Myasthenia
 gravis is muscle weakness disease that can be found in children, 
adults, and the people of this clinical tua.Sindrom was first presented 
in 1600. At the end of the 1800s began to be distinguished from myasthenia gravis muscle weakness due to bulbar paralysis. In
 1920 a doctor who suffers from myasthenia gravis was no improvement 
after taking ephedrine he intended to treat menstrual cramps.Myasthenia
 gravis is a lot of signage at the age of 20 years, the ratio between 
women and men who suffer from this disease is 3:1. Ages the second most frequent disease was an older man. Deaths
 from the disease Myasthenia gravis is usually caused by respiratory 
insufficiency, but can do improvements in intensive care for a defense 
so the complications that arise can be dealt with better. Healing
 can occur in 10% to 20% of patients by performing elective timektomi in
 certain patients and are best suited to the road to recovery is a group
 like this young lady, the age of onset. Age of onset of myasthenia gravis is 20-30 for women and 40-60 for men.
1. DefinitionMyasthenia
 gravis is an autoimmune disorder of peripheral nerves such as the 
formation of antibodies against the nicotinic acetylcholine receptor 
pascasinaps mioneural junction resulting in decrease in the number of 
acetylcholine receptors and decreased muscle strength progressively 
recovered after the break.
2. EpidemiologyMyasthenia gravis is a rare disease, and can occur at any age. Usually the disease is more commonly seen in the age of 20-50 years. Women more often than men suffer from this disease. The ratio of women and men who suffer from myasthenia gravis is 3: 1. In
 women, the disease appears at a younger age, which is about 20 years, 
whereas in men, the disease often occurs at the age of 40 years. In
 infants, approximately 20% of infants born to mothers with myasthenia 
myasthenia gravis will have no settled / transient (sometimes 
permanently). (Dewabenny, 2008).
 3. Etiology and Risk FactorsPrimary
 abnormality in myasthenia gravis associated with transmission 
impairments in the neuromuscular junction, the junction between the 
nerve elements and elements of muscle. At the end of the motor neuron axons are globular particles which is the accumulation of acetylcholine (ACh). If
 the motor stimuli arriving at ujungakson, globular particles burst and 
release Ach force that can move the nerve which then reacts with the ACh
 receptor (ACHR) on the membrane postsinaptik. This
 reaction opens ion channels in the membrane of the muscle fibers and 
cause the influx of cations, particularly Na, thus terjadilahkontraksi 
muscle.
 The exact cause transmission impairments neromuskuler in Myasthenia gravis is unknown. It
 used to say, there is a lack in Myasthenia gravis ACh ataukelebihan 
cholinesterase, but according to the latter theory, imunologiklah 
factors that played a role. (Qittun, 2008).
Risk factors for myasthenia gravis include:1. Age 20 to 402. Female sex3. Family history for myasthenia gravis4. Other autoimmune disease Rheumatoid arthritis and Lupus5. D-penicillamine consumption
4. ClassificationClinical Classification of myasthenia gravis can be divided into:Group I: ocular myastheniaJust attack the ocular muscles, with ptosis and diplopia. Very light, no deaths.
Group IIA: Myasthenia generally mildLate onset, usually in the eye, gradually spread to the skeletal muscles and bulbar. The respiratory system is not exposed. Better response to drug therapy. The mortality rate is low.
Group IIB: Myasthenia common beingOften
 accompanied by gradual onset and ocular symptoms, and continued getting
 heavier with terserangnya all skeletal muscles and bulbar. Dysarthria, dysphagia, and difficulty chewing more real than the common light myasthenia gravis. Respiratory muscles are not affected. Response to drug therapy unsatisfactory and limited patient activity, but low mortality.
Group III: acute severe myastheniaRapid onset with weakness of skeletal muscles and severe bulbar accompanied begin terserangnya respiratory muscles. Disease usually develops within 6 months maximum. Poor response to the drug. Incident miastenik crisis, cholinergic, or a combination of both high crisis. A high mortality rate.Group IV: severe myasthenia upMyasthenia gravis weight further raised at least 2 years after onset of symptoms in group I or II. Myasthenia gravis developed gradually or suddenly. Response to drugs and poor prognosis.
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