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Myasthenia Gravis: Treatment, symptoms, advice and help

About Myasthenia Gravis

Myasthenia Gravis is an autoimmune disorder in which the antibodies of the body’s immune system attack and destroys its own cells. In this case, the antibodies destroy the receptor of acetylcholine, thereby blocking its function. Acetylcholine is a neurotransmitter responsible for the transmission of nerve impulses to the muscles. Myasthenia Gravis is a neuromuscular disorder affecting the transmission between nerves and the corresponding muscles. The disease is characterized by weakness and fatiguability of the voluntary muscles (muscles which are under one’s conscious control). Myasthenia Gravis can be controlled with appropriate medications and if required, surgical intervention can be done.

Myasthenia Gravis: Incidence, age and sex

Myasthenia Gravis is a rare disease affecting about 15 per 100,000 individuals. It may be encountered in individuals of any age and belonging to any ethnic group. The disease frequently affects young adult women and older men.

Signs and symptoms of Myasthenia Gravis: Diagnosis

The chief symptom of Myasthenia Gravis is muscle weakness which increases after repeated activity or exercise. Myasthenia Gravis may affect any voluntary muscle of the body but commonly involves facial muscles, muscles associated with eye movements and swallowing. Drooping of eyelids, difficulty in closing eyes, inability to blow a whistle, distorted smile, difficulty in chewing food and swallowing are the some of the commonly observed symptoms. Arms are more commonly involved as compared to thigh and leg muscles. Affected individuals may find difficulty in activities like combing hair, difficulty in getting up from squatting position or climbing stairs. The course of the disease is extremely variable and may differ from person to person. It may have a sudden onset or gradual onset, subside for many years and again recur or may have a continuous relapsing and a remitting course.

The diagnosis of Myasthenia Gravis is made after careful study of medical history and comprehensive physical examination. A blood test may be done to detect antibodies against acetylcholine. Electromyography (EMG) is a sensitive test which is done to detect the neuromuscular disorder and establish the diagnosis.

Causes and prevention of myasthenia gravis

Myasthenia Gravis is an immunologically mediated disorder wherein the antibodies of body’s immune system attack and destroys its own cells. Individuals who have other autoimmune disorders like diabetes mellitus or thyroid disease are at increased risk for Myasthenia Gravis. Moreover, it may also arise due to the dysfunctioning of the thymus gland. The thymus gland is a small glandular organ which is a part of the body’s immune system.

Myasthenia Gravis: Complications

There may be involvement of respiratory muscles resulting in respiratory distress. This phenomenon is termed as Myasthenic Crisis which is potentially fatal.

Myasthenia Gravis: Treatment

Myasthenia Gravis has no cure but with the available treatment modalities, the symptoms can be relieved and remissions can be reduced to a minimum. Treatment is individualized depending on the age of patient, duration, severity and the variable course of the illness. The degree of functional disability is also considered in planning therapy. Medication like anticholinesterases (pyridostigmine) is the first choice in managing the condition. Other medications include low-dose oral steroids (Prednisolone) or immunosuppressant drugs (Azathioprine) may also be considered in individuals who do not respond to first line medication. Sometimes, thymectomy (surgical removal of the thymus gland) may prove to be beneficial in some individuals, especially those who have a poorly functioning thymus gland. The individual is able to live a normal healthy life with proper treatment.