Anesthestics worsen MG muscle weakness?

[bny806]

I was just curious if anesthetics worsen MG weakness?? When I had my epidural 18 months ago (At the time I felt well as to be expected- my muscles weren't exactly strong, but I was pregnant and taking care of a toddler and working- so to be excpected I thought)!
WHen I got my epidural my muscles seemed to be abnormally weak in all the places that they months later became weak - my tongue/face, and well everywhere but my left lower leg really. They almost had to intubate me as it appeared the epidural went too high and I wasn't breathing well.. They put me on Bipap.. Anyhow. looking back I wonder (esp with the tongue and face weakness at that time), if whatever this issue was already taking over my body! ?! (would LEMS be affected?)

[scrubbs]

When I get an epidural I ask for the smallest dose of anesthetic possible just because I hate the way I feel afterwards. I here them ask the Dr. 2 or 3 and I do not remember which is which but at one of those two levels I am awake the whole time and thats what I like.

scrubbs

[lawgirl]

I'm very keen to see the responses to this - I'm due to have a general anaesthetic soon and I don't even know if I can. Even if I'm monitored DURING the surgery, a lot of my respiratory weakness doesn't set in until the day after having heavy meds...

Very scary about the epidural - I never knew it could go up too high, that's terrifying!!! You poor thing!

[Anacrusis]

Hi bny806

That´s certainly an interesting question!

I´m interested in myasthenia that might be pregnancy related......

Originally Posted by lawgirl

a lot of my respiratory weakness doesn't set in until the day after having heavy meds...

I´ve had exactly the same Lawgirl. Do you know the reason why the reaction takes so long?

I was looking around and the only thing I found about medication and delayed presentation of myasthenic symptoms was this:

"Myasthenia gravis exacerbations developed a median of 1 day following fluoroquinolone exposure. The 37 cases describe dyspnoea (n = 19; 51%), myasthenic crisis requiring ventilatory support (n = 11; 30%) and death (n = 2; 5%). Additional exacerbation-related adverse events were generalized muscle weakness (n = 20; 54%), dysphagia (n = 9; 24%), diplopia (n = 6; 16%) and ptosis (n = 6; 16%). Six patients (16%) experienced a positive rechallenge, with recurrent myasthenia gravis exacerbation after fluoroquinolone reintroduction."

Extract taken from:
http://www.unboundmedicine.com/medli...rature_review_

Good luck with that operation - Hope your doctor can figure this out - at least have someone monitoring you/people with you the day after.

Anacrusis