Muscular System Case #1 A thirty-five year old male presents to your clinic comp
ID: 3511731 • Letter: M
Question
Muscular System Case #1 A thirty-five year old male presents to your clinic complaining. "I look old and my eyelids are sagging." He also states that he sometimes feels like he is wearing a hat with a big brim. He is otherwise healthy without any documented medical illness. Visual acuity is 20/20 uncorrected. Pupils are reactive to light and without afferent papillary defect. External examination is significant for bilateral ptosis; OD greater than OS. Palpebral fissure height is 6 mm OD; 9 mm OS. Marginal reflex distance (MRD,) is 2 mm OD; 4 mm OS. Levator function is borderline with 10 mm excursion. In the clinic, an ice-test is performed which confirms your suspicion. What is the most likely diagnosis? What medical diagnostic test can be administered to confirm your suspicion? What is the drug class and the mechanism of action for the above pharmacological agent? . .What laboratory test can you order to confirm your diagnosis? What are the side effects from ptosis surgery?Explanation / Answer
myasthenia gravis
it can be diagnosed with the following
Reflexes
Muscle strength
Muscle tone
Senses of touch and sight
Coordination
Balance
Acetylcholine esterase (AChE) inhibitors are considered to be the basic treatment of myasthenia gravis (MG). Edrophonium is primarily used as a diagnostic tool because of its short half-life. Pyridostigmine is used for long-term maintenance. High doses of corticosteroids commonly are used to suppress autoimmunity.
The anti–acetylcholine receptor (AChR) antibody (Ab) test is reliable for diagnosing autoimmune myasthenia gravis (MG)
Unusual swelling after surgery.
Post operative Infection.
Asymmetrical eyelid height.
Overcorrection or undercorrection.
Dry spots
Stiffness of the eyelid when the patient looks down
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