Myasthenia gravis
Myasthenia gravis is a rare long-term condition that causes muscle weakness.
It most commonly affects the muscles that control the eyes and eyelids, facial expressions, chewing, swallowing and speaking. But it can affect most parts of the body.
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Myasthenia Gravis is usually an autoimmune condition. it is rarely inherited and is never contagious. It generally develops later in life when antibodies in the body attack normal receptors on muscle. This blocks a chemical needed to stimulate muscle contraction. A temporary form of myasthenia gravis may develop in the fetus when a woman with myasthenia gravis passes the antibodies to the fetus. Generally, it resolves in 2 to 3 months.
Your doctor can diagnose myasthenia gravis based on your symptoms and certain tests.
.Blood tests. These tests look for antibodies that may be present in people with myasthenia gravis.
Genetic tests. These tests are done to check for conditions that run in families.
Nerve conduction studies. A test called repetitive nerve stimulation is used to diagnose myasthenia gravis.
Electromyogram (EMG). A test that measures the electrical activity of a muscle. An EMG can detect abnormal electrical muscle activity due to diseases and neuromuscular conditions.
There is no cure for myasthenia gravis, but the symptoms can often be controlled. Myasthenia gravis is a lifelong medical condition. Early detection is the key to managing the condition. The goal of treatment is to increase muscle function and prevent swallowing and breathing problems. Most people with this condition can improve their muscle strength and lead normal or near normal lives. In more severe cases, help may be needed for breathing and eating.
The most serious complications of myasthenia gravis is a myasthenia crisis. This is a condition of extreme muscle weakness, particularly of the diaphragm and chest muscles that support breathing. Breathing may become shallow or ineffective. The airway may become blocked because of weakened throat muscles and build up of secretions. Myasthenia crisis may be caused by a lack of medicine or by other factors, such as a respiratory infection, emotional stress, surgery, or some other type of stress. In severe crisis, a person may have to be placed on a ventilator to help with breathing until muscle strength returns with treatment.
Symptoms of myasthenia gravis:
Common symptoms of myasthenia gravis include:
- droopy eyelids;
- double vision;
- difficulty making facial expressions;
- problems chewing and difficulty swallowing;
- slurred speech;
- weak arms, legs or neck;
- shortness of breath and occasionally serious breathing difficulties.
The symptoms tend to get worse when you’re tired. Many people find they’re worse towards the end of the day, and better the next morning after getting some sleep.
Message UsComplications:
Myasthenic crisis
Myasthenic crisis is a life-threatening condition that occurs when the muscles that control breathing become too weak to work. Emergency treatment and mechanical assistance with breathing are needed. Medications and blood-filtering therapies help people to again breathe on their own.
Underactive or overactive thyroid.
The thyroid gland, which is in the neck, secretes hormones that regulate your metabolism. If your thyroid is underactive, you might have difficulties dealing with cold, weight gain and other issues. An overactive thyroid can cause difficulties dealing with heat, weight loss and other issues.
Thymus gland tumors.
Some people with myasthenia gravis have a tumor in the thymus gland, a gland under the breastbone that is involved with the immune system. Most of these tumors, called thymomas, aren’t cancerous (malignant).
Autoimmune conditions.
People with myasthenia gravis might be more likely to have autoimmune conditions, such as rheumatoid arthritis or lupus.
How is myasthenia gravis treated?
Specific treatment for myasthenia gravis will be determined by your healthcare provider based on:
- How old you are
- Your overall health and medical history
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long the condition is expected to last
- Your opinion or preference
There is no cure for myasthenia gravis, but the symptoms can often be controlled. Myasthenia gravis is a lifelong medical condition. Early detection is the key to managing the condition.
The goal of treatment is to increase muscle function and prevent swallowing and breathing problems. Most people with this condition can improve their muscle strength and lead normal or near normal lives. In more severe cases, help may be needed for breathing and eating.
Treatment may include:
Medicine. Anticholinesterase medicines, steroids, or medicines that suppress the immune system’s response (immunosuppressive) medicines may be used.
Thymectomy. This is surgical removal of the thymus gland. The role of the thymus gland in myasthenia gravis is not fully understood, and the thymectomy may or may not improve symptoms. However, it reduces symptoms in more than 70% of people who do not have cancer of the thymus, possibly by altering the immune system response.
Plasmapheresis. A procedure that removes abnormal antibodies from the blood and replaces the blood with normal antibodies from donated blood.
Immunoglobulin. A blood product that helps decrease the immune system’s attack on the nervous system. It is given intravenously (IV).
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When should I call my healthcare provider?
Call your doctor if any of these occur:
- Drooping eyelid
- Blurred or double vision
- Slurred speech
- Problems chewing and swallowing
- Weakness in the arms and legs
- Chronic fatigue
- Trouble breathing
Myasthenia Gravis treatment
Factors that can worsen myasthenia gravis
- Fatigue
- Illness or infection
- Surgery
- Stress
- Some medications — such as beta blockers, quinidine gluconate, quinidine sulfate, quinine (Qualaquin), phenytoin, certain anesthetics and some antibiotics
- Pregnancy
- Menstrual periods
Outlook for myasthenia gravis
Myasthenia gravis is a long-term condition that typically has phases when it improves and phases when it gets worse.
It usually affects most of the body, spreading from the eyes and face to other areas over weeks, months or years. In about 1 in 5 people, only the eye muscles are affected.
Treatment can usually help keep the symptoms under control. Very occasionally, myasthenia gravis gets better on its own.
If severe, myasthenia gravis can be life-threatening, but it does not have a significant impact on life expectancy for most people.