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Myasthenia Gravis
Myasthenia Gravis is a neuromuscular disease resulting in weakness of the voluntary muscles.  This weakness is particularly prominent after repeated use of the muscle group.  Myasthenia Gravis is caused by an autoimmune reaction within the body where antibodies are formed against neurotransmitter receptors in the nerve junction. These antibodies attack receptors for the neurotransmitter acetylcholine.  Acetylcholine is essential for voluntary muscle movement. With less acetylcholine present in the nerve junction, muscles fatigue faster than normal.  

Symptoms
The hallmark symptom of Myasthenia Gravis is fatigability of voluntary muscles. Any muscle group may be affected.  However, the muscles of the face and swallowing are most commonly affected. Common symptoms include drooping eyelids, slurred speech, difficulty swallowing and shortness of breath in extreme cases.

Treatment

Overall treatment of Myasthenia Gravis includes daily medications that prolongs the acetylcholine in the nerve junction and minimizes the autoimmune reaction. If daily medication is not enough to control the symptoms of Myasthenia Gravis, several intravenous medications are available. In extreme cases, surgery may be needed to stop the immune reaction within the body. In the event of an acute flair or crisis, patients are admitted to the hospital to receive intravenous medication and hourly monitoring to protect breathing and swallowing.

Guillian Barre
Guillian Barre Syndrome is also known as an ‘Acute Inflammatory Demylenating Polyneuropathy”. Guillian Barre is caused by an autoimmune response causing the myelin sheath of the nerve to breakdown.  Guillian Barre often appears several weeks after a viral infection and was associated with the influenza vaccine in the 1970s.  It has not been associated with any particular vaccine since.

Symptoms
This breakdown results in a slowed transmission of the nerve impulse resulting in weakness.  Weakness generally begins in periphery first. The weakness is generally symmetrical and starts in the feet and progresses up the body.  The degree and speed of progression depends on the disease process in each person.  In extreme cases, Guillian Barre may progress to affect the breathing and swallowing muscles.  In theses cases, patients are generally admitted to the hospital to support their breathing and swallowing.

Diagnosis
The diagnosis of Guillian Barre is generally made by combining the history of symptoms with a detailed neurologic exam and nerve conduction testing. Most cases of Guillian Barre are diagnosed and managed on an outpatient basis.  If breathing or swallowing muscles are threatened or affected, the patient is admitted to the hospital to receive care from a specialist.

Treatment
Treatment for Guillian Barre generally includes intraveneous medication or blood filtration to minimize the autoimmune response.