What is the Difference Between Myasthenic Crisis and Cholinergic Crisis?
🆚 Go to Comparative Table 🆚Myasthenic crisis and cholinergic crisis are two different conditions that can occur in patients with myasthenia gravis (MG). Both conditions involve muscle weakness, but they have distinct causes and treatments.
Myasthenic Crisis:
- Occurs when a person with MG experiences a sudden worsening of muscle weakness.
- Symptoms include overall weakening and difficulty swallowing, breathing, or talking.
- The annual risk of myasthenic crisis among people with MG is low at just 2 to 3 percent.
- Can be triggered by infections, certain medications, or other factors.
Cholinergic Crisis:
- Occurs when a person with MG is taking very high doses of acetylcholinesterase inhibitors, which cause toxicity in the muscarinic and nicotinic receptors.
- Symptoms are similar to myasthenic crisis, but the cause is different.
- Rarer than myasthenic crisis in people with MG.
To differentiate between these two conditions, an edrophonium test can be used. In a myasthenic crisis, administration of 2 mg of edrophonium will improve muscle weakness, while in a cholinergic crisis, the clinical symptoms will worsen. Identifying which condition is causing the muscle weakness is crucial for proper treatment and management.
Comparative Table: Myasthenic Crisis vs Cholinergic Crisis
Myasthenic crisis and cholinergic crisis are both complications of myasthenia gravis, but they have different causes and clinical manifestations. Here is a table highlighting the differences between the two:
| Feature | Myasthenic Crisis | Cholinergic Crisis |
|---|---|---|
| Definition | A life-threatening complication of myasthenia gravis, characterized by worsening muscle weakness, resulting in respiratory failure and requiring intubation and mechanical ventilation. | A rare complication caused by an excess of acetylcholinesterase inhibitors, leading to muscle weakness, fasciculations, and various toxicities. |
| Causes | Triggered by factors such as infection, reaction to medication, surgery, pregnancy, or childbirth. May also occur due to taking lower doses of immunosuppressive medicines or in the natural course of myasthenia gravis. | Caused by an excessive dosage of acetylcholinesterase inhibitors. |
| Symptoms | Muscle weakness, severe dyspnea, respiratory insufficiency, and aspiration. | Muscarinic toxicity (miosis, bradycardia, diarrhea, salivation, warm and red skin), nicotinergic effects (cramping, muscle weakness, fasciculation). |
| Diagnostic Differentiation | Improvement in muscle weakness when administered edrophonium. | No improvement or worsening of weakness when administered edrophonium. |
| Treatment | Medical intervention, such as intubation and mechanical ventilation, to support respiratory function. | Reducing or discontinuing acetylcholinesterase inhibitors, atropine administration. |
Prompt diagnosis and appropriate treatment are crucial for managing both myasthenic and cholinergic crises. If you or a loved one experiences symptoms consistent with either of these crises, seek immediate medical attention.
- Myasthenia Gravis vs Cholinergic Crisis
- Parkinson’s vs Myasthenia Gravis
- Muscular Dystrophy vs Myasthenia Gravis
- Myasthenia Gravis vs Lambert Eaton Myasthenic Syndrome
- Guillain Barre Syndrome vs Myasthenia Gravis
- Cholinergic vs Anticholinergic
- Myasthenia Gravis vs Lambert Eaton Syndrome
- Adrenergic vs Cholinergic Receptors
- Muscarinic vs Nicotinic Receptors
- Choline vs Acetylcholine
- Catecholamines vs Acetylcholine
- Myopathy vs Neuropathy
- Neostigmine vs Pyridostigmine
- Nicotinic vs Muscarinic Receptors
- Neostigmine vs Physostigmine
- Muscular Dystrophy vs Myotonic Dystrophy
- Malignant Hyperthermia vs Neuroleptic Malignant Syndrome
- Thyrotoxicosis vs Hyperthyroidism
- Myokymia vs Fasciculations