Question

In your opinion, which disease is more difficult in diagnosis and management (Multiple sclerosis or Myasthenia gravis) and why?
. What is the prognosis for each disease? Nursing intervention that should be considered

Answer 1

Myasthenia gravis (MG) is the one of the common disorder associated with neuromuscular transmission. The basic cause is an acquired immunological abnormality whereas in few of the cases it results due to genetic abnormalities at the neuromuscular junction.

Multiple sclerosis is a disease which affects the brain and spinal cord, resulting in a wide range of symptoms such as problems with vision, arm or leg movement, sensation or balance.

In both of these diseases, fatigue is the common symptom. In case of myasthenia gravis which is caused due to peripheral fatigue whereas multiple sclerosis is caused due to central fatigue. And the detection of peripheral fatigue is difficult as compared to central fatigue. Hence the diagnosis and management of multiple sclerosis is difficult when compared to myasthenia gravis.

Prognosis of multiple sclerosis - it has been estimated that all multiple sclerosis patient the chance of walking unaided in 15 years following disease onset is 50%. More than half of the patient needs walking assistance. Most of the disease modifying agent used in this disease have slowed disability progression. Less than 5–10% of patients have a clinically less the phenotype of the disease, in which no significant physical disability accumulates despite the passage of several decades after onset (sometimes in spite of multiple new lesions seen on MRI).

Prognosis of myasthenia gravis - with proper care, treatment most patient have a normal life span . Mortality rate is 3-4% with greater risk to individuals who are more than 40 years. Medicine used results in causing adversely affect. Morbidity results from impairment of muscle strength may results in aspiration, increased incidence of pneumonia, falls, respiratory failure if treatment is not done.