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]

Presentation History Bilateral diaphragmatic paralysis is characterized by profound abnormalities of pulmonary and respiratory muscle function. [emedicine.medscape.com]

for achalasia is a well-tolerated procedure with few side effects, such as transient chest pain and heartburn; rarely, cases of mediastinitis, esophageal mucosal ulceration, and pneumothorax have been reported. 1-4 Case Report A 90-year-old female presented [acgcasereports.gi.org]

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]

• 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]

  Patients also report anxiety, insomnia, morning headache, excessive daytime somnolence and fatigue, and poor sleep habits. [emedicine.medscape.com]

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

• 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]

• Hypersomnia

  Both the reduction in strength and endurance of the respiratory muscles are causing alteration of the sleep structure, primarily reducing quantity of rapid eye movement (REM) sleep hypersomnia. [shortnessofbreath.it]

• 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]

• Epigastric Pain

  pain and coffee-ground emesis. [acgcasereports.gi.org]

  In some patients, nonspecific GI symptoms such as heartburn, regurgitation, nausea, and epigastric pain can also develop. [9] In bilateral diaphragmatic paralysis, additional clues to diagnosis include dyspnea further exacerbated in a swimming pool or [emedicine.medscape.com]

• 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]

  Patients also report anxiety, insomnia, morning headache, excessive daytime somnolence and fatigue, and poor sleep habits. [emedicine.medscape.com]

  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]

• Cervical Cord Compression

  At this time, the differential diagnosis included atypical Guillain-Barre syndrome (GBS), cervical cord compression, and systemic botulism as a complication of endoscopic BTI. [acgcasereports.gi.org]

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]

[…] well as training theory; 2) an understanding of how disease affects the respiratory muscles and the mechanics of breathing; 3) an insight into the disease-specific, evidence-based benefits of RMT; 4) advice on the application of RMT as a standalone treatment [books.google.com]

Most patients with post–cardiac surgery diaphragmatic dysfunction improve with conservative measures such as chest physiotherapy, prevention and treatment of pneumonia, treatment of underlying chronic obstructive pulmonary disease (if present), and overall [emedicine.medscape.com]

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]

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]

Rothen HU, Sporre B, Engberg G, Wegenius G, Reber A, Hedenstierna G (1995) Prevention of atelectasis during general anesthesia. Lancet 345:1387–1391 PubMed CrossRef Google Scholar 52. [link.springer.com]

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

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]