Myasthenia Gravis is a chronic autoimmune disorder.  There is no cure, but with treatment people with this disorder can live normal or nearly normal lives.  The goal of treatment is to relieve signs and symptoms of the disorder. 

Myasthenia Gravis causes weakness and rapid muscle fatigue of any skeletal muscle.  There is a breakdown of normal communication between the nerves and muscles from antibodies that are produced by the immune system.  These antibodies block or destroy the muscle receptors.  This blockage causes the neurotransmitters to be fewer causing fewer signals and resulting in muscle weakness. 

Myasthenia Gravis usually affects women younger than the age of 40 and men older than the age of 60.  

 

Symptoms

Symptoms of myasthenia gravis are weakness and rapid muscle fatigue.  This can affect any voluntary muscles.  Primarily it affects the eyes, mouth, throat, and limbs. 

This condition can cause difficulty breathing and swallowing.  In severe cases breathing assistance may be needed.  Muscle weakness with myasthenia gravis comes and goes, but is usually better when the muscle is resting.  When a muscle that is affected by myasthenia gravis is being used it may weaken faster. 

More than half the people who have myasthenia gravis have the first sign of the condition with their eyes.  Myasthenia gravis can cause drooping of one or more eyelids.  It can also cause double vision that is either horizontal or vertical that improves when you close one eye. 

Fifteen percent of people with myasthenia gravis have symptoms in their face and throat muscles.  Weakness in these muscles can cause impaired speech, difficulty swallowing, choking easily, affected chewing, or change in facial expressions.  Chewing muscles may get tired halfway through eating a meal. 

Myasthenia gravis also can cause weakness in the neck, arms and legs.  Neck weakness can cause the ability to hold your head up to be affected.  Leg weakness can affect the ability to walk normally. 

 

Causes 

Myasthenia Gravis is caused by antibodies that are produced by the immune system.  These antibodies block the muscle receptors.  When the neurotransmitters are sent to the muscles the signal is less than normal causing muscle weakness. 

Many people who have myasthenia gravis also have an unusually large thymus gland.  The actual factor of the thymus gland with this condition is unknown.  There are treatments to remove the thymus gland that significantly help people with myasthenia gravis and their symptoms. 

It is rare for a mother with myasthenia gravis to pass it onto a child, but it can happen. 

 

 

Complications

Some factors can worsen the condition.  Fatigue, illness, surgery, stress, certain medications, pregnancy, and menstrual periods. 

Myasthenia crisis is the worst complication that can happen with this condition.  It is a severe muscle weakness of the diaphragm.  This severe muscle weakness can cause difficulty breathing. 

Myasthenia crisis can be brought on by lack of treatment or medication, or one of the other factors that can worsen myasthenia gravis.  

 

Diagnosis

Your doctor will be able to diagnose myasthenia gravis from your symptoms, medical history, as well as a few tests.  A blood test may be done to check for the antibodies that the condition produces.  Genetic testing can look for hereditary causes of the condition.  Nerve conduction studies are done with repetitive nerve stimulation.  An EMG or electromyogram can also be done to measure the electrical activity of the muscles. 

 

Treatment 

Treatment depends on your age, overall health, how sick the condition is making you, your ability to handle certain medicines, procedures, or therapies, as well as your preference for treatment.  There is no cure. 

Symptoms can be managed for someone who has myasthenia gravis to lead a normal life.  Early detection and treatment is key. The goal of treatment is to increase muscle function, and prevent swallowing and breathing problems.

One treatment option is a thymectomy.  This is a surgical procedure to remove the thymus gland.  This may or may not improve symptoms.  About 70% of the people who undergo a thymectomy have reduced symptoms.

Medications are another treatment option.  Anticholinesterase medicines may be given to help slow down the breakdown of the receptors, this will improve the neurotransmitter signals increasing the muscle strength.  Other medications are steroids, or immunosuppressant medication.

Plasmapheresis is another treatment option.  This procedure removes abnormal antibodies from the blood and replaces them with normal antibodies from donated blood.  Immunoglobulin which is given through an IV is a blood product that decreases the immune system’s attack on the nervous system.

 

Conclusion

People with myasthenia gravis can live normal or near normal lives.  Only in rare cases will someone need breathing assistance for treatment.  Some people after having treatment may go into remission.  This remission can be temporary or permanent.  Going into remission may mean that you are able to stop taking medication and have full strength back in your muscles that were affected. 

Early treatment is key to being able to help symptoms and regain strength back into your muscles.  

 

 

 

 


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