Myasthenia gravis is a disease that manifests itself in the form of muscle weakness and fatigue. Muscle weakness often causes paralysis. Most often, the disease affects the muscles of the eyes, face, tongue, lips, throat, neck and larynx. The disease is prone to progression, so you need to have an idea of ​​the symptoms and causes of myasthenia gravis. It is also necessary to identify it as soon as possible. In some people, it is clearly visible in external manifestations, but in any case, diagnosis is required. One of its methods is proserin test.
Forms of myasthenia gravis
Before answering the question of what is a proserin test, it is necessary to describe myasthenia gravis itself. There are three main forms of this disease:
- Eye myasthenia gravis. It is characterized by damage to the eye muscles (can often be found in older men).
- Bulbar form. Most often represents a further development of the ophthalmic. It is characterized by damage to the bulbar group of nerves (glossopharyngeal, sublingual).
- Generalized form. It is a combination of the signs of the two previous ones, but already with skeletal muscle damage.
Thus, with local forms (ocular and bulbar), weakness of certain muscle groups is observed, with a generalized form, the muscles of the trunk or limbs suffer.
Symptoms
The first step in diagnosing myasthenia gravis is to identify its symptoms. The main one is high muscle fatigue during long-term stress. As a rule, after several hours of break, muscle function is restored.
A more specific list of symptoms is as follows:
- “Voice Fade” during a conversation.
- Problems chewing food and swallowing it.
- Fatigue during movements, often not even very intense (walking, combing).
- Shuffling gait.
- Drooping eyelids.
The danger of myasthenia gravis lies in the apparent “routine” of symptoms that people often ignore. Therefore, myasthenia gravis is in many cases diagnosed when it is already becoming severe. Therefore, abnormally high fatigue, weakness and lethargy of muscles are potential signs of the disease and require examination to confirm or refute the diagnosis.
Myasthenic crisis
So in medicine is called the sharp appearance of muscle weakness, often reaching paralysis. Symptoms of the crisis are as follows:
- Breathing at first is shallow and frequent, followed by intermittent and rare. In this case, the patient is seized with anxiety, and his face first turns red, then turns blue. Fatal respiratory arrest may occur.
- The pulse quickens and blood pressure rises. Then the pulse becomes more rare and weak, and then - threadlike.
- There is a strong perspiration and salivation.
In the absence of timely assistance, the onset of oxygen starvation and brain damage is possible.
It is very important to distinguish between myasthenic crisis and cholinergic. The latter is similar to myasthenic, but occurs due to an overdose of drugs for myasthenia gravis.
Causes of the disease
Despite the fact that the symptoms of myasthenia are known, the causes of its occurrence are not fully established. Allocate congenital and acquired myasthenia gravis. Known cases of the combination of this disease with pathologies of the thymus gland indicate the involvement of this organ in the pathological process. Myasthenia gravis is also observed in diseases of the nervous system, cancer of the lungs, breast, ovaries, and prostate.
The essence of the pathology is the disruption of the neuromuscular connections. Muscles are driven by nerve impulses, which are transmitted using neurotransmitters. During myasthenia gravis, antibodies are produced that block or damage the receptors of the necessary neurotransmitters. Therefore, much less nerve signals reach the muscles, which leads to weakness.
Antibodies that damage neurotransmitter receptors are thought to be produced by an inflamed thymus (thymus gland).
The course of myasthenia can further worsen the following factors:
- Fatigue.
- The disease.
- Stress.
- Medications that affect the functioning of nerve receptors.
Diagnosis of myasthenia gravis
If the above symptoms appear, consult a neurologist. He will conduct an examination, identify complaints and signs that could go unnoticed. However, the use of a proserin test is necessary, since with a simple examination it is difficult to identify the disease.
What is Prozerin, general information
Proserine is a synthetic medicine. When used, it reduces heart rate, increases the secretion of glands (salivary, sebaceous, sweat, etc.), narrows the pupils, reduces pressure in the eye, tones muscles, causes bronchospasm. It is used not only for myasthenia gravis, but also in the treatment of this disease. When used in therapeutic doses, it improves the functioning of neuromuscular connections. In large doses, it itself can cause a violation of their work. Prozerin is available in ampoules for testing, and in 15 mg capsules for administration. Released by prescription.
Sample execution
The technique of the proserin test is the introduction of a Prozerin solution under the skin. Then, after 20-30 minutes, the doctor examines the patient to determine the reaction. In the presence of myasthenia gravis, its symptoms disappear after an injection of Proserinum. If there is no effect, they say that the proserin test is negative. Myasthenia gravis is absent in this case. For testing, only Prozerin in ampoules is used.
To perform this procedure, no special equipment or complex manipulations are required. It is enough to be able to put a simple subcutaneous injection. These are the main points that clearly explain how to conduct a proserin test.
Features of the use of the drug
Like any drug, Prozerin has its own indications and contraindications.
Indications:
- Myasthenia gravis
- Paralysis.
- Recovery period after encephalitis, meningitis.
- Atrophy of the optic nerve.
- Atony of the bladder and gastrointestinal tract.
- Normalization of the work of neuromuscular connections.
It is used both for adult patients and during pediatric therapy.
Contraindications to the use of Prozerin are:
- Hypersensitivity to the active substance.
- Epilepsy.
- Vagotomy.
- Diseases of the cardiovascular system.
- Bronchial asthma.
- Gastrointestinal diseases.
- Diseases of the genitourinary system.
- Pregnancy and lactation period.
Thus, although the proserin test in myasthenia gravis is a diagnostic tool, Prozerin itself can be used as a medicine. It should be noted that due to the short duration of the effect, for the treatment of myasthenia gravis "Proserin" is used only in combination with other drugs.
Side effects
Side effects of the drug affect various organs and organ systems of the patient. The side effects picture is as follows:
- Digestive organs: vomiting, nausea, diarrhea, increased gas formation.
- Nervous system: headaches and dizziness, weakness and drowsiness, cramps and cramps, blurred vision, trembling and involuntary muscle contraction.
- Cardiovascular system: cardiac arrhythmias, cardiac arrest.
- Respiratory: dyspnea, bronchospasm, respiratory arrest.
- Allergies: itching, rash, anaphylactic shock.
- Other: frequent urination, increased sweating.
How can I replace the proserin sample
Although this method is extremely effective, others apply. The list of some of them is as follows:
- Electromyography. Known as the decrement test. It is a measurement of the volume of bioelectric signals in muscles. It is carried out before and after the proserin test.
- Electroneurography. Checking the rate of transmission of a nerve signal to the synapse.
- Blood test for the presence of antibodies that block and damage the receptors of neurotransmitters.
- Genotype study. It is carried out to confirm or refute the hereditary nature of the disease.
- Computed tomography of the thymus. Allows you to identify changes in its size.
In addition, there are special tests to help identify the disease. They are quite simple and run at home. Here they are:
- You need to quickly open and close your mouth. Repeat these movements for forty seconds. In the absence of myasthenia gravis man has one hundred or more cycles.
- Lying on your back, you need to keep your raised head on the weight for a minute.
- Twenty squats need to be done with one amplitude.
- You need to quickly squeeze and unclench the brushes. With myasthenia gravis, this exercise can lead to drooping eyelids.
Treatment of myasthenia gravis
A complete cure for myasthenia gravis is impossible. Therapy is reduced to the formation of a stable remission in the patient. The main task is to increase the level of the neurotransmitter acetylcholine, which ensures the transmission of a nerve impulse to muscles. During therapy, the following types of drugs are used:
- Anticholinesterase drugs. Sometimes the name AHEP is found. These drugs neutralize cholinesterase, which usually destroys acetylcholine.
- Potassium preparations. They prolong the work of AHEP, improve muscle function.
- Cytostatics. Reduce the number of antibodies and immunity cells that produce them.
- Hormone medications. Reduce the severity of symptoms.
- Additionally, the doctor may prescribe immunoglobulins, immunosuppressants, antioxidants.
During an exacerbation of the disease, plasmapheresis, Proserinum, gamma irradiation of the thymus, a wider list of immunoglobulins are prescribed.
The treatment of myasthenia gravis takes a long time. In order for the therapy to lead to remission, some medications must be taken for life. During treatment, you need to constantly monitor blood pressure and blood sugar.
In the presence of a thymus tumor, an operation is performed.
Physiotherapy
Physiotherapy is widely used to treat myasthenia gravis. Its goal is also to improve neuromuscular connections, normalize tissue nutrition.
For the treatment of myasthenia gravis apply:
- Current stimulation.
- Inhalations with medicines.
- Electrophoresis of drugs (most often proserin).
- Electrostatic massage.
- Color therapy (used to influence the psyche).
- The usual massage.
During periods of remission and in the absence of myasthenic crises, sanatorium-resort treatment is allowed. Resorts of Crimea and Sochi are best suited.
Before conducting spa treatment, you need to make sure that the patient does not have contraindications to this form of therapy.
It should be noted that none of the methods of physiotherapy can be used separately, in isolation from the main treatment.
Forecast
Despite the severity of the disease, myasthenia gravis is compatible with a comfortable and eventful life. In order for therapy to be successful, strict adherence to the regimen consisting in the timely intake of the necessary drugs is necessary. Non-compliance with the threat of relapse attacks, up to the likelihood of a crisis.
The inadmissibility of any self-medication is also obvious. When the first signs of myasthenia appear, you must immediately visit a neurologist!
Prevention
If a person is diagnosed with myasthenia gravis, severe physical exertion and prolonged exposure to the sun are contraindicated. Food should be low in calories. It is necessary to take medications both directly against myasthenia gravis and those supporting immunity (medications to support immunity are recommended only during remission). Antipsychotics, diuretics, tranquilizers and some antibiotic groups are contraindicated.
The best form of prevention of myasthenia gravis, like any other disease, is an attentive attitude to your health. Remember: in no case should you self-medicate, and if you have health problems, you should immediately go to the doctor!
Conclusion
Due to the non-obviousness of the symptoms and causes of myasthenia gravis, quick and effective methods of diagnosing this pathology are required. In addition, when it is detected, complex therapy is necessary. Proserine test is the fastest, easiest and most reliable way to diagnose myasthenia gravis. Prozerin itself is an integral element of the complex therapy of the disease.