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Facts About Myasthenia Gravis (MG)

After 22 years as an RN, I now write about medical issues and new medical advances. Diet, exercise, treatment, and lifestyle are important.

Drooping Eye

Drooping Eye

Overview of Myasthenia Gravis

Myasthenia gravis (MG) is a chronic autoimmune disorder that is a difficult disease. MG is a rare disorder that affects the neuromuscular transmission that leads to skeletal muscle weakness affecting more than 700,000 people worldwide.

It typically affects women under the age of forty and men over age sixty. It is uncommon in children. This is not an inherited disease nor is it contagious. There is no cure for MG, but there are treatments. Myasthenia gravis is a lifelong medical condition. Early detection is important in controlling this disease.

Symptoms of MG

In MG the antibodies (neurotransmitters) destroy communication between the nerves and the muscles, which causes skeletal muscle weakness. These antibodies attack the normal muscle receptors, blocking a necessary chemical necessary for muscle contraction. Voluntary muscles are particularly affected.

The most common symptoms include:

  • Visual problems - drooping eyelids (ptosis), double vision (diplopia) which may be horizontal or vertical, and it may improve with one eye closed
  • Muscular weakness and fatigue that may rapidly increase over a few days or possibly hours
  • Weakness in the legs can change the way you walk
  • Facial muscle weakness that projects a mask-like appearance (a smile might look like a snarl)
  • Trouble chewing and swallowing or difficulty in pronouncing words
  • Weakness in the limbs or neck making it difficult to hold

These symptoms may mimic other conditions, so it is important to see your physician.

Weakness

Weakness

Diagnosis of MG

Myasthenia gravis is diagnosed in several ways. A physical exam and a review of your symptoms would be completed first. Your neurological health will be evaluated and includes the following testing:

  • Reflexes
  • Muscle strength
  • Muscle tone
  • Sense of touch and sight
  • Coordination
  • Balance

Other possible testing includes:

  • Blood tests are done to look for antibodies present in people with MG. Patients with MG usually have high levels of acetylcholine receptor antibodies in their blood.
  • Nerve conduction studies (repetitive nerve stimulation) may be ordered.
  • An Electromyogram (EMG) is a test that measures the electrical activity of the muscle. It can detect abnormal activity in the muscle due to neuromuscular conditions and other diseases.
  • An ice pack test may be done for a drooping eyelid. An ice pack is held on the eyelid for two minutes to see if there is any improvement.
  • A MRI or CT scan of the thymus gland may be ordered for some patients to check for any irregularity, such as a tumor.

There are some conditions that increase the risk of getting MG, Including:

  • A history of autoimmune diseases, such as rheumatoid arthritis or systemic lupus
  • Infections
  • Medications for malaria, heart arrhythmias, cancer
  • Surgical procedures
  • Thyroid disease
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Another way to diagnose MG is to test a patient’s response to particulate medications. For instance, muscle weakness often improves in a dramatic fashion for a short amount of time with anticholinesterase medicine. This response confirms the disease.

A pregnant woman with MG may pass a temporary form of myasthenia gravis to her fetus, which resolves within two to three months.

Thymus Gland

Thymus Gland

Treatments

Your physician will determine the best course of treatment by your age, overall medical history, your symptoms and how well you can handle specific medications, therapies or treatments. The goal is to prevent further muscle function, prevent swallowing or breathing problems. The bulk of the patients can improve their muscle strength and lead a near normal life. These treatments include:

Medications include anticholinesterase medications, steroids or other medications that suppress the immune system.

The surgical removal of the thymus gland, which reduces the MG symptoms in 70% of patients. The role of the thymus gland is not fully understood.

Precautions

  • Patients with this disease should use the following precautions to minimize the symptoms or complications of the disease.
  • Take anticholinesterase medicines 30 to 45 minutes before meals to reduce the chance of aspiration (food entering the lung passages)
  • Take anticholinesterase medications as prescribed to maintain strength in the muscles that help breathing.
  • Balance periods of activity with periods of rest.
  • Avoid crowds and contact with any individual that has a respiratory infection or a cold.
  • Consume proper nutrition to maintain optimal weight and muscle strength.
  • Use stress reduction techniques and avoid emotional extremes.

What is myasthenia gravis?

Myasthenia Gravis Patient Registry

The Myasthenia Gravis Patient Registry provides a database of people with this disease, and it was developed for the purpose of research, treatment and to provide patient information. This Registry is looking for new patients to provide their MG data. Hopefully, this will direct researchers to design trials that provide new treatments.

Research

There is a lot of research into Myasthenia gravis focused on new treatments. There is active research for new antigens in an attempt to regulate the immune system. In addition, they are searching for biomarkers that will help with early diagnosis, and they are studying patient outcomes to understand the full impact of living with this disease.

Symptoms and Disease Course of Myasthenia Gravis

Final Thoughts

Myasthenia gravis is surely a difficult disease, but when treated early the symptoms will typically be lessened. The treatments usually lessen the symptoms, even though there is no cure. There is a great deal of research that hopefully will be successful with new treatments and maybe a cure.

References

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2022 Pamela Oglesby

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