What is myasthenia gravis?

Thanks, Adamu, for your useful question. Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. Myasthenia gravis is a type of autoimmune disorder which occurs when the immune system mistakenly attacks healthy tissue. In people with myasthenia gravis, the body produces antibodies that block the muscle cells […]

Thanks, Adamu, for your useful question. Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them. Myasthenia gravis is a type of autoimmune disorder which occurs when the immune system mistakenly attacks healthy tissue. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cell. Antibodies are proteins made by the body’s immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue a harmful substance such as in the case of myasthenia gravis. The exact cause of myasthenia gravis is unknown. In some cases, it is linked to tumors of the thymus (an organ of the immune system).
Myasthenia gravis can affect people at any age. It is most common in young women and older men.

Symptoms
Myasthenia gravis causes weakness of the voluntary muscles. Voluntary muscles are those that are under your control. Autonomic muscles, such as the heart and the digestive tract, are usually not affected. The muscle weakness of myasthenia gravis worsens with activity and improves with rest.
The muscle weakness can lead to a variety of symptoms, including:
·   Breathing difficulty because of weakness of the chest wall muscles
·         Chewing or swallowing difficulty, causing frequent gagging, choking, or drooling
·    Difficulty climbing stairs, lifting objects, or rising from a seated position
·         Difficulty talking
·         Drooping head
·         Weakness of the facial muscles
·         Fatigue
·         Hoarseness or changing voice
·         Double vision
·         Difficulty maintaining steady gaze
·         Eyelid drooping
Treatment
There is no known cure for myasthenia gravis. Treatment may allow one to have periods without any symptoms (remission). Lifestyle changes often help one continue daily activities.
The following may be recommended:
·         Resting throughout the day
·         Using an eye patch if double vision is bothersome
·         Avoiding stress and heat exposure, which can make symptoms worse
·         Medicines could also be prescribed to suppress the immune system response.
·  Crisis situations are attacks of weakness of the breathing muscles. These attacks can occur without warning when either too much or too little medicine is taken. These attacks usually last no longer than a few weeks. One may need to be admitted to the hospital where you may need breathing assistance with a ventilator.
Other treatment options are as follows:
·         A procedure called plasmapheresis may also be used to help end the crisis. This procedure involves removing the clear part of the blood (plasma), which contains the antibodies. This is replaced with donated plasma that is free of antibodies or with other fluids. Plasmapheresis may also help reduce symptoms for 4 to 6 weeks and is often used before surgery.
· Another procedure, called immunoglobulin infusion, may also be done. With this procedure, a large amount of helpful antibodies are given directly into the bloodstream.
·  Surgery to remove the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present.
·   If you have eye problems, your doctor may suggest lens prisms to improve vision. Surgery may also be recommended to treat your eye muscles.
·         Physical therapy can help maintain your muscle strength. This is especially important for the muscles that support breathing.
· Some medicines can worsen symptoms and should be avoided. Before taking any medicine, check with your doctor whether it is okay for you to take.
· One can also ease the stress of illness by joining a myasthenia gravis support group. Sharing with others who have common experiences and problems can help you not feel alone.