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Old 09-03-2012, 07:08 AM
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alice md alice md is offline
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alice md alice md is offline
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Join Date: Sep 2009
Posts: 884
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I personally do not like using the word myasthenic crisis.

First, because its not clear how it is defined. (every neurologist defines it differently).

Second, it conveys something which happens, can't be predicted and we have no control over. We can only sit and watch and hope for the best. It also conveys a clear outcome-either recovery or death.

The "crisis" of pneumonia (which was very eloquently described by Hippocrates) no longer exists, because we know how to recognize early signs of pneumonia and we know how to treat it. We no longer have to sit next to a patient's bad and see if he/she turns for the better or for the worse.

Crisis means turning point. The worst point of the illness after which the patient either dies of begins to make a recovery. After a crisis ends the patient may suffer sequalae of the disease but has fully recovered from the disease itself.
It has nothing to do with the respiratory failure which can be brought about by respiratory muscle involvement in MG. A respiratory " crisis" in MG is not a turning point but a severe and potentially life-threatening complication of the disease. Most times a myasthenic crisis does not lead to death nor to recovery. A patient may have more than one episode of severe respiratory muscle weakness during the course of his/her illness.

We do not use the word crisis to describe a severe asthma attack or any severe manifestation of any other illness. Why use this term to describe it in MG? I think it also encourages neurologists to regard crisis as some mystical occurrence instead of encouraging them to have a better and deeper understanding of the full spectrum of respiratory manifestations of MG.

I think it also creates needless and understandable anxiety in patients who feel that without any warning signs they can just stop breathing.
As opposed to patients with asthma who are given clear parameters to follow and are educated how to recognize early signs of danger, patients with MG are not given any tools to recognize or prevent more severe and potentially dangerous manifestations of the disease.
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"Thanks for this!" says:
Anacrusis (09-04-2012), southblues (09-03-2012), StephC (09-03-2012)