Myasthenia Gravis - Symptom, Treatment And Causes

The disease Myasthenia gravis results in muscles that tire and become weak easily. It may interfere with everyday activities as common as chewing food. If a patient has this disease his jaw muscles may tire soon and affect his food intake. After some rest, they may let the patient continue as usual. In fact, this tendency of tiring with little use then resumption of the normal state with a little bit of rest is the characteristic hallmark of this particular disease.

Myasthenia gravis is a condition in which neuromuscular systems if damaged and affecting skeletal muscles. When the eye muscles are affected, the symptoms such as eyelid drooping, blurry or double vision are complained by the patient. The severity of damage to the neuromuscular system is varying person to person.

Other symptoms such as difficulty in walking, swallowing, pronouncing words and chewing, muscular weakness in regions such as arms, hands, fingers, legs and neck, the occurrence of hoarse voice, effect of paralysis on facial areas, fatigue are also associated with myasthenia gravis condition. Some people also complain about problem of breathing that is occurred due to reducing the strength of muscle of respiratory system and neck regions.

In the case of normal operations of nerves and muscles, nerves send directions to muscles to work by sending chemical messages through an area which is known as a receptor in biological terminology. The message is delivered through the chemical acetylcholine. The muscle knows it’s time to contract when acetylcholine binds itself to a nerve receptor. If a person is suffering from myasthenia gravis basically they have lesser amounts of acetylcholine receptors than what is needed by the body to function normally.

This disease is an autoimmune disorder. In cases of such diseases, the antibodies of the body mistakenly attack ones’ own body parts eventually destroying them. Antibodies are special proteins with the purpose of protecting the body from threats like viruses, bacteria or fungi. If one is affected by myasthenia gravis his or her antibodies attack, block or destroy the acetylcholine receptors that are essential for contraction of muscles. The disease is suspected to be connected with the thymus.

Diagnosis of myasthenia gravis is based upon the symptoms and done under the supervision of a specialist. Important steps involved in the diagnosis of myasthenia gravis include the following:

• Physical examination: In this step, a detailed physical examination of the patient is involved asking him/her about the symptoms.
• Medical history: The patient is asked about medical history if present. This may include any systemic diseases or disorders which are present currently or were present in the individual at some point in their lives.
• Response to certain medicines: On administration of anticholinesterase medicines, symptoms such as muscle weakness are improved.
• Other tests: These tests including blood tests, genetic tests, nerve conduction studies, and electromyogram, are for the confirmation of the disease.

Summary: Myasthenia gravis is diagnosed on the basis of symptoms, medical history, response to certain medicines, and tests including blood tests, electromyogram, genetic tests, etc. This is an important step based on which treatment plan is decided.

As myasthenia gravis is an autoimmune disease, there is a first need for controlling the immune system. Depending on the age of person, medical history and overall health, current symptoms, ability to handle medication, therapies or procedures, etc, the decision about the suitable treatment is taken. The control on the immunity system can be primarily possible by use of medication such as immunosuppressive agents (prednisone, azathioprine, tacrolimus).

Other treatments recommended or prescribed for Myasthenia gravis are anticholinesterase medications (Mestinon, pyridostigmine), Plasmapheresis and intravenous immunoglobulin therapies, and Thymectomy (surgical removal of thymus gland). The surgical removal of thymus gland is performed for people to not only overcome symptoms of Myasthenia gravis but also to reduce risk of cancer. When this condition reaches to severe stage, Plasmapheresis and intravenous immunoglobulin therapies are suggested.

If a person is having any type of autoimmune disease history in family or personal levels, then he or she will be at higher chances of occurrence of myasthenia gravis. In general, myasthenia gravis is found in women age 20 to 40 years while after the age of 60 years in men. But it can occur at any stage or age of life and it can be worse if a person is having stress, fatigue or other illness. This disease cannot be compared with other diseases that are inherited. A very rare occurrence of myasthenia gravis in infants or children is observed that is coming from mother with myasthenia gravis. If so, then the symptoms will generally disappear after two to three months.

Myasthenia gravis involves lifelong treatment. However, it is important to follow some guidelines in order to improve the outcome of the treatment. Those include:

• Regular medical check-ups and follow-ups under the supervision of the treating doctor.
• Avoiding overexertion
• Doing mild forms of exercises on a regular basis
• Taking a well-balanced diet to prevent any nutritional deficiencies or malnutrition
• Taking medicines on time
• Skipping medicine doses should be avoided

Summary: The symptoms associated with Myasthenia gravis can be controlled and managed by proper treatment methods. Thus, it is important to follow proper guidelines post-treatment so as to keep an eye on the health of the affected individual, preventing any further complications.

Myasthenia gravis is a chronic autoimmune disorder. Its exact cause is still unknown. There has been no cure of the disease known so far, however, the symptoms tend to be relieved with an early diagnosis followed by prompt medical management.

The life span of the affected individual can be significantly increased along with the improvement in the quality of his/her life.

Summary: Myasthenia gravis is a lifelong disease, hence complete recovery is not possible in such cases. With early detection and prompt medical treatment, the symptoms can be relieved to ensure a better life for the affected individual.

The treatment of Myasthenia gravis mainly involves medications such as Pyridostigmine. The application of this medicine relieves symptoms only for a few hours, thus having a temporary outcome. Hence, the results of the treatment of this disease are not permanent. The disease is lifelong and so is the treatment involved in it.

Summary: Myasthenia gravis is treated with medicines like Pyridostigmine. The outcome of this treatment is temporary, not permanent, hence needs to be continued till whole life.

Since myasthenia gravis is an autoimmune disease, its prevention is not possible. However, if it already occurs in an individual, the severity of the symptoms can only be controlled. Some of the preventive measures include:

• Preventing infections by maintaining proper personal hygiene and avoiding contact with the infected people.
• If any kind of infection occur in the affected individual, it should be treated promptly.
• Overexertion should be avoided.
• One should avoid overheating or too cold conditions.
• Stress management should be done.

Summary: Being an autoimmune disease, Myasthenia gravis cannot be prevented. However, with appropriate treatment, it is possible to prevent the worsening of the symptoms.

Myasthenia gravis affects neuromuscular junction, thus leading to weakening of lips, jaw, throat, and tongue. It causes difficulty in swallowing and increases fatigue while eating. Hence, it is important to be careful about the food items so as to prevent aggravation of symptoms in such conditions. Some of the preferred foods include:

• Semi-solid foods: Such food items are easier to swallow than solid or dry food items. Examples include gravy-rich foods, yogurt, broth, butter, mayonnaise, etc.
• Fish or chicken: Fish or chicken are easier to chew and swallow as compared to meats.
• Easily chewable foods: These include egg salad, fruit smoothies, shakes, canned salmon, etc.
• Smaller meals: Small and frequent meals are preferred in place of larger meals.
• Chopped or minced forms of foods are preferred as they are easier to swallow.

Summary: Due to weakening of the muscles of lips, jaw, throat, and tongue, symptoms like difficulty in swallowing and chewing are evident in myasthenia gravis. Hence, selective food items including easily chewable semi-solid foods and smaller meals are preferred.

The treatment of myasthenia gravis mainly involves the application of intravenous medications such as monoclonal antibodies, Rituximab, and Eculizumab. Side effects experienced with their use mainly include:

• Feeling of dizziness
• Frequent or occasional chills
• Moderate to severe headaches
• Fluid retention in the body

Summary: The treatment of Myasthenia gravis involves the application of medicines like Rituximab, Eculizumab, etc. which shows dizziness, chills, headaches, and fluid retention as some of the side effects.

There may arise a need for emergency care when Myasthenia gravis is accompanied by ‘’Myasthenia crisis’’, a condition triggered by respiratory infection, fever, or side effects of certain medications.

This leads to impaired breathing as well as swallowing due to excessive weakening of the muscles involved. Emergency treatment is required in these cases by providing mechanical assistance with breathing.

Another emergency situation may also arise in the form of a ‘’cholinergic crisis’’. It is caused due to excessive consumption of the drug Mestinon, leading to severe difficulties in breathing and swallowing. Such conditions also need urgent medical care and treatment.

Summary: Myasthenia gravis is associated with certain emergency conditions such as ‘myasthenia crisis’ and ‘cholinergic crisis’. These require emergency medical care and treatment to prevent any severe complications.

The price of treatment of myasthenia gravis mainly includes costs related to the outpatient department consultation which is around INR 15000 per patient along with the patient’s admission cost which is on an average of INR 60,000.

Thymectomy, the surgical procedure involved in the removal of the abnormally enlarged thymus gland, usually costs around INR 45000.

Summary: The price of the treatment of myasthenia gravis mainly includes costs related to outpatient department consultation, patient admission in the intensive care unit, and surgical treatment like thymectomy and medications.

Individuals suffering from myasthenia gravis face extreme weakness in their skeletal muscles. As a result, they are unable to do most of the regular physical activities due to an increased risk of exertion, followed by fatigue. Due to such pre-existing activity, the individuals tend to develop a feeling of frustration or get annoyed on getting into any form of exercise.

It is better for them to avoid exhaustive or high impact exercises, however, mild or low impact may be preferred. Aerobics such as mild forms of walking, swimming, or jogging can be done in such conditions.

Summary: Physical exercises may play a role in reducing fatigue of the skeletal muscles in individuals with Myasthenia gravis. However, only mild forms of exercises such as walking, jogging, swimming should be preferred.

Home remedies to overcome symptoms of myasthenia gravis can be lifestyle changes and diet changes. The things that should be accepted to treat myasthenia gravis are consumption of more fruits and vegetable along with food rich with omega -3 fatty acids, potassium, replacing the animal protein with the other plant protein, removing milk and milk products from diet and replace them with other substitutes of calcium, scheduling frequent rest periods during any type of activity etc. If a person is experiencing double or blurry vision, then use an eye patch to relieve the problem. Other remedies can also include the use of safety precautions at home such as railings, and grab bars in the bathroom and being stress-free.

In Myasthenia gravis, neuromuscular junction is mainly affected, followed by its impaired functioning. The first and basic medicine preferred in such conditions is Pyridostigmine, which helps in the transmission of the electrical impulses between nerves and muscles.

The effect of this medicine lasts for a few hours only, thus needs to be taken several times a day under the supervision of a specialist.

Summary: In myasthenia gravis, neuromuscular junction is mainly affected, leading to weakening of muscles. The best-preferred medicine in this condition is Pyridostigmine as it helps in the transmission of neuromuscular impulses, thus minimizing the related symptoms.

Myasthenia gravis is a lifelong autoimmune disorder with no cure. The treatment mainly involves the application of certain medicines, which provide relief on a temporary basis only. However, there are certain alternatives to the treatment which mainly include the following:

• Ayurveda
• Homeopathy
• Naturopathy
• Acupuncture
• Chinese or oriental medicines

Summary: Besides basic treatment with medicines, Myasthenia gravis may also be controlled by some alternative methods including acupuncture, homeopathy, naturopathy, Ayurveda, etc.