A 34-year-old lady presented with generalised weakness of body, indistinguishable from myasthenia gravis within 24 hours of a wasp sting. [ncbi.nlm.nih.gov]

In developing its educational products ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. [atsdr.cdc.gov]

Presentation History Weakness : In 60% of cases, onset occurs approximately three weeks after a viral illness. The condition usually presents with an ascending pattern of progressive symmetrical weakness, starting in the lower extremities. [patient.info]

It usually affects the ocular muscles first and presents as ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are present in 90% of cases. [guillain-barre.co.uk]

Congenital disorder of the brain related to paralysis is present in cerebral palsy. [health-tutor.com]

• Fatigue

  Physical effects The person may experience fatigue, poor balance, slurred words, a weak grip, tripping when walking, or other minor symptoms. Sometimes this stage occurs before a diagnosis is made. [mda.org]

  After aprodromal phase (paraesthesias, restlessness, irritaility, fatigue, and myalgias) neurological symptoms will start with paralysis of the lower extremities. The deep tendon reflexes are weak or absent. [cvbd.org]

  We have to make a clear distinction between muscle fatigue and muscle weakness. While fatigue is changing over rest, weakness is not. [shortnessofbreath.it]

  if you suspect that there is residual fatigue of the inspiratory muscles, take a day off. keep an IMT diary. [physio-pedia.com]

  It is the principal muscle of respiration, is innervated by the phrenic nerves that arise from the nerve roots at C3 through C5, and is primarily composed of fatigue-resistant slow-twitch type I and fast-twitch type IIa myofibers. • What is the most characteristic [blogs.nejm.org]

• Falling

  You may lose your balance and fall, which can cause injury or even death if you fall into machinery that can crush you. High voltages can also cause severe burns (as seen on pages 9 and 10). [elcosh.org]

  There is a fall in serum potassium preceding weakness, but in some patients the level may never fall below normal. 54 Johnsen's series of provocative studies recorded an episode of weakness of 11 hours duration provoked by a 0.3 mmol/L fall in the serum [hkpp.org]

  If a fall occurs, the person may not be able to stand back up alone. Driving is relinquished. Weakness in swallowing muscles may cause choking and greater difficulty eating and managing saliva. [mda.org]

  Other causes of nerve damage fall into group of polyneuropathies. Polyneuropathy usually does not lead to significant locomotive disruption; it is rather associated with unpleasant tingling, burning or pain in the peripheral parts of the body. [health-tutor.com]

  Risk for falls related to decreased sensorium for 2 to 4 days postoperatively D. Impaired gas exchange due to the CNS depressant effect of general anesthesia A patient is recovering from general anesthesia. [quizlet.com]

• Collapse

  J98.19 Other pulmonary collapse J98.2 Interstitial emphysema J98.3 Compensatory emphysema J98.4 Other disorders of lung J98.5 Diseases of mediastinum, not elsewhere classified J98.59 Other diseases of mediastinum, not elsewhere classified J98.6 Disorders [icd10data.com]

  - Cardiovascular collapse may occur. - Several conditions may increase sensitivity to NMBDs. [quizlet.com]

  SDB in neuromuscular disease mainly comprises alveolar hypoventilation but upper airway collapse may also occur because pharyngeal muscle tone is impaired by both neuromuscular weakness and sleep. [clinicaltrials.gov]

  Discussion Rapid collapse of alveoli on induction of anesthesia and more widespread closure of airways seem to explain the oxygenation impairment and may also contribute to postoperative pulmonary infection. [link.springer.com]

  The buildup of mucus can result in atelectasis ((at-uh-LEK-tuh-sis), which is a collapse of all or a portion of the lung. [msktc.org]

• Unconsciousness

  - General anesthetics are used during surgical procedures to produce: --- Unconsciousness --- Skeletal muscular relaxation --- Visceral smooth muscle relaxation --- Electroconvulsive therapy for severe depression The practice of using combinations of [quizlet.com]

  TO AVOID DISTRESS TO THE PATIENT, SUCCINYLCHOLINE SHOULD NOT BE ADMINISTERED BEFORE UNCONSCIOUSNESS HAS BEEN INDUCED. IN EMERGENCY SITUATIONS, HOWEVER, IT MAY BE NECESSARY TO ADMINISTER SUCCINYLCHOLINE BEFORE UNCONSCIOUSNESS IS INDUCED. [rxlist.com]

  Reflexes are fast, unconscious muscular reactions that occur due to unexpected physical stimuli. The action potentials for reflexes originate in the spinal cord instead of the brain. [en.wikibooks.org]

  Although patients with GBS in the setting of preserved consciousness may be described as obtunded, patients may be fully lucid; ambiguities in deciding whether some individual patients are truly unconscious, in a vegitative state, or simply locked-in [guillain-barre.co.uk]

• Hypoxemia

  Abstract Background Oxygenation is impaired in almost all subjects during anesthesia, and hypoxemia for shorter or longer periods is a common finding. [link.springer.com]

  Do not wait for ABGs to show hypoxemia or hypercapnia. These are late developing signs that appear only immediately prior to respiratory arrest in MG patients. [myasthenia.org]

  Acute respiratory distress syndrome (ARDS) is a lethal syndrome characterized by hypoxemia, bilateral infiltrates and diffuse alveolar damage.(1) Patients presenting with ARDS often require intubation and mechanical ventilation for hypoxemic respiratory [sccm.org]

• Dyspnea

  Patients usually are asymptomatic at rest but may experience dyspnea upon exertion and may have a decrease in exercise performance. [12] If the patient has an underlying lung disease, dyspnea may occur at rest. [emedicine.medscape.com]

  When symptomatic, the following may be noted : Difficulty breathing when physically active (exertional dyspnea). Reduced endurance. Mild orthopnea – difficulty breathing when lying down. [healthhype.com]

  SDB often starts long before exertional dyspnea or orthopnea develop. [clinicaltrials.gov]

  Dysfunction of one or both hemidiaphragms is an underdiagnosed cause of dyspnea. [blogs.nejm.org]

  Shortness of breath on exertion (dyspnea) Need to sleep sitting up (orthopnea) Retention of carbon dioxide (CO 2 ) morning headaches poor concentration and impaired intellectual function Sleep disturbances not feeling rested in the morning sleepiness [gbppa.org]

• Loss of Appetite

  (Image: tameek/iStock/Getty Images) Nicotine exposure causes acute action on the smooth muscles of the gastrointestinal tract, resulting in a loss of appetite. [livestrong.com]

  C. botulinum in infants include constipation, loss of appetite, weakness, an altered cry and a striking loss of head control. [who.int]

  It is a rare manifestation of serum sickness or a transient syndrome resembling serum sickness with hematuria, loss of appetite, nausea, vomiting, and stomach pain accompanied by weakness (tired feeling), chills, low grade fever and possible evidence [guillain-barre.co.uk]

• Thrombosis

  Deep vein thrombosis (DVT) prophylaxis : DVT due to immobility should be prevented with gradient compression stockings and subcutaneous low molecular weight heparin. See separate Prevention of Venous Thromboembolism article. [patient.info]

  Many secondary complications may follow GBS that include dysautonomia, deep vein thrombosis, anemia, immobilization, and pain and sensory involvement (J. M., Meythaler, 1997; J. M. Meythaler, M. J. De Vivo, and W. C. Braswell, 1997). [guillain-barre.co.uk]

• Ulcer

  She remained there for 4 months without improvement in clinical status, with her course further complicated by ventilator-associated pneumonia, urinary tract infection, and decubitus ulcers. [acgcasereports.gi.org]

  […] genetic abnormalities of plasma cholinesterase (e.g., patients heterozygous or homozygous for atypical plasma cholinesterase gene), pregnancy, severe liver or kidney disease, malignant tumors, infections, burns, anemia, decompensated heart disease, peptic ulcer [rxlist.com]

• Muscular Atrophy

  atrophy with respiratory disease (SMARD) : an ethical dilemma Bush A Intensive care medicine, 2006, 32, 11, p. 1691-1693 Respiratory failure in infants due to spinal muscular atrophy with respiratory distress type 1 Giannini A, Pinto AM, Rossetti G, [myobase.org]

  In childhood the most common neuromuscular disorders are Duchenne’s muscular dystrophy (DMD) and spinal muscular atrophy. Both conditions start early during childhood, but nowadays last up to the third or even the forth decade of life ( 1 – 3 ). [shortnessofbreath.it]

• Headache

  When the reactive inflammatory processes are restricted to the meninges, an aseptic meningitis with headache as the chief manifestation results. [clevelandclinicmeded.com]

  Severe headache in Guillain-Barré syndrome is rare; an initial episode of a headache, vomiting, fever and back and limb pain is usually followed by paralysis. [guillain-barre.co.uk]

  Poor respiration may cause fatigue, fuzzy thinking, headaches, and susceptibility to pneumonia. (Respiratory insufficiency is a leading cause of death in ALS.) Speech, or eating and drinking by mouth, may not be possible. [mda.org]

  Bilateral Rapid shallow breathing Difficulty breathing even at rest Pronounced orthopnea Anxiety Disturbed sleep Fatigue Morning headache Clinical examination reveal absence of or severely dulled breathing sounds, inward movement of the abdomen when inhaling [healthhype.com]

  - Acute pain related to the adverse effect of spinal headache from epidural anesthesia. - Deficient knowledge related to lack of information about anesthesia. - Risk for injury related to the impact of any form of anesthesia on the CNS (CNS depression [quizlet.com]

• Guillain-Barré Syndrome

  syndrome... [4] All About Guillain-Barré Syndrome, S. [guillain-barre.co.uk]

  Sensory findings are generally absent and therefore form an important differential diagnostic symptom to the Guillain-Barré syndrome where sensory findings are frquently found during the prodromal stage of disease. [cvbd.org]

  A rare acute polyneuropathy known as Guillain-Barré syndrome causes progressive paralysis. Note: The most common and fortunately only temporary paralysis of nerves is caused by local effect of longer physical pressure, most often during sleep. [health-tutor.com]

  Cerebellar syndrome is a prominent feature of West Nile virus infection. Neurology.. 60: 2003; A97. The Guillain-Barré syndrome. N Engl J Med. 326: 1992; 1130-1136. Guillain-Barré syndrome associated with West Nile virus infection. [clevelandclinicmeded.com]

  Synonym: acute inflammatory polyneuritis Guillain-Barré syndrome (GBS) is a disorder causing demyelination and axonal degeneration resulting in acute, ascending and progressive neuropathy, characterised by weakness, paraesthesiae and hyporeflexia. [patient.info]

• Limb Weakness

  […] contrast to the headache and mental status alterations that are the usual manifesting symptoms, weakness often evolves and develops in the subacute phase of the illness. 11,12 The limb weakness is of a lower–motor neuron pattern, with flaccid tone, areflexia [clevelandclinicmeded.com]

  Limb weakness is the first sign in 10 percent of patients. The arm and leg muscles may weaken, affecting activities such as lifting or walking. [medicalnewstoday.com]

Cardiac evaluations using serial ECGs with measurements of the QTc interval are essential and should be performed on all patients undergoing workup for periodic paralysis. 23, 24, 25 References 1. [hkpp.org]

• Atelectasis

  Causative mechanisms to atelectasis and airway closure seem to be loss of respiratory muscle tone and gas resorption. [link.springer.com]

  A: Chest radiographs may reveal elevated hemidiaphragms and basal subsegmental atelectasis. Although chest radiography is a reasonably sensitive tool for detecting unilateral diaphragmatic paralysis (90%), its specificity is unacceptably low (44%). [blogs.nejm.org]

  The buildup of mucus can result in atelectasis ((at-uh-LEK-tuh-sis), which is a collapse of all or a portion of the lung. [msktc.org]

  On the other hand patients with reduced ability of cough are also at risk of developing pulmonary atelectasis and recidive pulmonary infection. Effective cough can only be produced with a MEP higher than 50–60 cm H 2 0 ( 4 ). [shortnessofbreath.it]

• Hypercapnia

  Validation has to be carried out with regard to both daytime hypercapnia and nocturnal retention of carbon dioxide because the latter often represents the earliest manifestation of respiratory muscle weakness. [clinicaltrials.gov]

  Do not wait for ABGs to show hypoxemia or hypercapnia. These are late developing signs that appear only immediately prior to respiratory arrest in MG patients. [myasthenia.org]

  At the first signs of nocturnal hypercapnia, the patient should be offered NIV therapy rather than waiting until the hypercapnia extends into the daytime period. [shortnessofbreath.it]

  Instead, the CO 2 accumulates (called hypercapnia), and thus there is decreased room in the alveoli for oxygen. Hypercapnia and decreased oxygen saturation are the hallmarks of underventilation or hypoventilation. [gbppa.org]

  […] exercised in the following events: history of spontaneous pneumothorax traumatic pneumothorax that has not fully healed burst eardrum or other conditions of the eardrum unstable asthma with abnormally low perception of dyspnoea Precautions Minimise hypercapnia [physio-pedia.com]

The treatment of botulism is administration of antitoxin followed by supportive care as well as intensive physical therapy. 5 Overall, with prompt recognition and treatment, botulism has a relatively low mortality rate of 5 This exceedingly rare case [acgcasereports.gi.org]

Treatment With myasthenia gravis, the limbs can weaken. There is no cure for myasthenia gravis, but treatment with immunosuppressants or cholinesterase inhibitors can help control symptoms. [medicalnewstoday.com]

Botox treatments employ the purified and heavily diluted botulinum neurotoxin type A. [who.int]

Treatment Termination of the exposure including removing all soiled clothing. Gently cleanse with soap and water to hydrolyze organophosphate solutions. Airway control and adequate oxygenation. [openanesthesia.org]

All four patients responded well to treatment. [jpma.org.pk]

A decrease to less than 20% of predicted normal is associated with a poorer prognosis. [patient.info]

A positive correlation exists between MIP and 6MWT, indicating that respiratory muscle training (RMT) can directly influence exercise tolerance in stroke survivors and contribute to better prognosis and survival. [pnmedical.com]

Long-term prognosis for clinical West Nile virus. Emerg Infect Dis. 10: 2004; 1405-1411. Back to Top [clevelandclinicmeded.com]

Prognosis Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist, such as areflexia. [guillain-barre.co.uk]

Year introduced: 1973(1968) PubMed search builder options Subheadings: analysis anatomy and histology blood cerebrospinal fluid chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology etiology [ncbi.nlm.nih.gov]

The approach to the patient with hypokalemic paralysis includes a vigorous search for the underlying etiology and potassium replacement therapy. Further therapy depends on the etiology of the hypokalemia. [jpma.org.pk]

Etiology [ edit ] Cholinergic crisis, sometimes known by the mnemonic "SLUDGE syndrome", [2] can be a consequence of: Contamination with - or excessive exposure to - certain chemicals including: nerve agents, ( e.g. sarin, VX, Novichok agents ). organophosphorus [en.wikipedia.org]

A higher number of patients in the cisatracurium group had pneumonia as the primary etiology of ARDS, while those who received the placebo had more intra-abdominal sepsis as the source. [sccm.org]

It is considered significant when the distance between the surface of the anterior wall of the thorax and the deepest part of the depression is greater than 3 cm. 21 Its etiology is unknown, although a close relation to the Marfan syndrome has been found [archbronconeumol.org]

Year introduced: 1973(1968) PubMed search builder options Subheadings: analysis anatomy and histology blood cerebrospinal fluid chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology [ncbi.nlm.nih.gov]

Epidemiology The incidence of typical GBS in Europe is 1.2-1.9 per 100,000 [ 3 ]. There is an increased incidence in males. Peak ages are 15-35 years and 50-75 years. [patient.info]

Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study. Intensive Care Med. 2004;30:51-61. 2. Ranieri VM, Rubenfeld GD, Thompson BT, et al. [sccm.org]

Back to Top Epidemiology Since its first isolation in the West Nile district in Uganda in 1937, WNV has become endemic throughout Africa and areas of the Middle East, where the prevalence of WNV antibody among children is 3.5% to 8%. 1–3 Since the mid [clevelandclinicmeded.com]

Following a brief examination of the force these muscles are required to exert in normal conditions, we review the pathophysiology of some characteristic alterations brought about by a) chest wall diseases such as kyphoscoliosis; b) other diseases involving [archbronconeumol.org]

Hypokalemic paralysis: A review of the etiologies, pathophysiology and therapy, Am. J. Emerg. Med., 1992; 10:143-8. 3. Gabow, P.A. Disorders associated with an altered anion gap. Kidney Int., 1985;27:472-483. 4. Battle, D. Renal tubular acidosis. [jpma.org.pk]

Patients seldom recall a specific mosquito bite, but they are often self-reported active persons with significant outdoor—and therefore mosquito—exposures. 12 Back to Top Pathophysiology WNV is a member of the Japanese encephalitis complex of viruses [clevelandclinicmeded.com]

Prevention Prevention of foodborne botulism is based on good practice in food preparation particularly during heating/sterilization and hygiene. [who.int]

[…] chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology etiology genetics history immunology metabolism microbiology mortality nursing parasitology pathology physiology physiopathology prevention [ncbi.nlm.nih.gov]

Prevention - Your first defense is to do whatever you can to prevent respiratory health problems. Here is a checklist. Do not smoke and stay away from secondhand smoke! Exposure to tobacco smoke is the worst thing you can do for your health. [msktc.org]

Prevention MG cannot be prevented. However, a person can take steps to stop a flare-up of symptoms or prevent them from developing complications. [medicalnewstoday.com]

"They will give you enough pain medication to prevent you from feeling it" The nurse is administering an NMBD to a patient during a surgical procedure. [quizlet.com]