Neurologische, neuromusculaire en psychiatrische pathologie
Neurologische, neuromusculaire en psychiatrische pathologie
Neurologische, neuromusculaire en psychiatrische pathologie
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Myast<strong>en</strong>ia Gravis<br />
• Auto-immune ziekte met aantasting van de postsynaptische<br />
acetylcholine receptor thv de motorische eindplaat<br />
• Spierzwakte (rust >< inspanning)<br />
– Oogled<strong>en</strong> <strong>en</strong> extra-oculaire spier<strong>en</strong><br />
– Craniale z<strong>en</strong>uw<strong>en</strong><br />
» faciaal: mimiek<br />
» bulbaire spier<strong>en</strong>: kauw- <strong>en</strong> slikproblem<strong>en</strong><br />
– Respiratoire spier<strong>en</strong>: vnl. tijd<strong>en</strong>s miast<strong>en</strong>ie crisis<br />
• Diagnose<br />
– Anticholinesterase test (edrophonium 2-8 mg)<br />
– Electromyografie<br />
– Serum: anti-acetylcholine AL<br />
• Behandeling<br />
– Orale anticholinesteras<strong>en</strong> (pyridostigmine,MESTINON)<br />
– Immunosuppressiva (corticoid<strong>en</strong>, azathioprine, cyclosporine)<br />
– Plasmaferese ( ↓ pseudocholinesterase / circul. AL )<br />
– Thymectomie
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