Myasthenic crisis lies along the fault-line between neurology and pulmonology. This creates a potentially dangerous situation, wherein nobody is fully informed or wholly responsible for the patient. To complicate matters further, traditional dogmas surrounding the monitoring of pulmonary function and indications for intubation are frequently wrong. This chapter attempts to provide a reasonable approach to myasthenic crisis. However, high-quality evidence is is largely absent, so a considerable amount of clinical judgement is required.
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The IBCC chapter is located here.
- The podcast & comments are below.
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I just finished the Emergency Neurological Life Support course offered by the Neuro Critical Care Society, and according to them, you can in fact, use Succynilcholine on MG patients but it is dosed at 2.5 times the normal dose.
Maybe, maybe not. I doubt there is great evidence given how rare severe myasthenic crisis is. Roc will definitely work.
Why use something that might work instead of something that will?
Is there a preferred first line pressor for treatment of hypotension associated with myasthenic crisis? Does the degradation of acetylcholine receptors change the response to norepinephrine?
Hi Dr. Farkas
Huge Thanks for your web book
Just wanted to ask that in third line of cholinergic crisis management, there should be written “lower doses of acetylcholinesterase inhibitors may be reintroduced” OR just “acetylcholinesterase”?
You are doing amazing.
Lots of respect from Pakistan.