Myasthenia gravis and respiratory failure related to phrenic nerve lesion

2008 ◽  
Vol 38 (4) ◽  
pp. 1340-1341 ◽  
Author(s):  
Anabela Valadas ◽  
Mamede de Carvalho
Keyword(s):  
Respiratory Failure ◽  
Myasthenia Gravis ◽  
Phrenic Nerve ◽  
Nerve Lesion

scholarly journals Postoperative Phrenic Nerve Palsy, A Cause Of Prolonged Mechanical Ventilation In Trans-Sternal Thymectomy

2015 ◽  
Vol 3 (3) ◽  
pp. 122-125
Author(s):  
Mona Sharma
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Myasthenia Gravis ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Prolonged Mechanical Ventilation ◽  
Myasthenic Crisis ◽  
Phrenic Nerve Palsy ◽  
Thoracic Epidural ◽  
Grade Iii

Post trans-sternal thymectomy, the patient may develop respiratory failure, usually due to myasthenic crisis or cholinergic crisis. These crises may prolong mechanical ventilation and impede on-table extubation. We report a case of respiratory failure due to unilateral phrenic nerve palsy in a case of myasthenia gravis. A 35 year old female, known case of myasthenia gravis was posted for trans-sternal thymectomy. Anaesthesia was induced with Propofol, Fentanyl and low dose of Atracurium. Thymoma was incasing right subclavian vein and was adherent with the pericardium, Masaoka Grade III. Blood loss was approximately 200ml. Immediate post operative period showed low tidal volume, tachypnea and tachycardia in spite of train of four ratio >0.9. Patient was kept intubated with suspicion of myasthenic crisis and the dose of Pyridostigmine was increased, but this lead to increased cholinergic symptoms. Pain was addressed with thoracic epidural analgesia. Chest radiograph done later in the evening showed elevated right hemi diaphragm, thereby, confirming the diagnosis of phrenic nerve palsy.   Difficult dissection in this case has resulted in right phrenic nerve palsy. Phrenic nerve palsy has to be considered as a cause of respiratory failure post sternotomy thymectomy, especially in case of Masaoka grade III and IV.DOI: http://dx.doi.org/10.3126/jkmc.v3i3.12249Journal of Kathmandu Medical CollegeVol. 3, No. 3, Issue 9, Jul.-Sep., 2014, Page: 122-125

scholarly journals Myasthenia Gravis Presenting Initially as Acute Respiratory Failure

2014 ◽  
Vol 60 (1) ◽  
pp. e14-e16 ◽  
Author(s):  
S. J. Lee ◽  
J. Hur ◽  
T. W. Lee ◽  
S. Ju ◽  
S. H. Lee ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Myasthenia Gravis

Severe Congenital Myasthenia Gravis of the Presynaptic Type with Choline Acetyltransferase Mutation in a Chinese Infant with Respiratory Failure

Neonatology ◽  
2009 ◽  
Vol 95 (2) ◽  
pp. 183-186 ◽  
Author(s):  
Wai L. Yeung ◽  
Ching W. Lam ◽  
Lai W.E. Fung ◽  
Kam L.E. Hon ◽  
Pak C. Ng
Keyword(s):  
Respiratory Failure ◽  
Myasthenia Gravis ◽  
Choline Acetyltransferase ◽  
Congenital Myasthenia

scholarly journals Unilateral phrenic nerve lesion in Lyme neuroborreliosis

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Marija Djukic ◽  
Jörg Larsen ◽  
Paul Lingor ◽  
Roland Nau
Keyword(s):  
Phrenic Nerve ◽  
Lyme Neuroborreliosis ◽  
Nerve Lesion
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