Myasthenia Gravis Symptoms, Causes, Diagnosis, And Treatment
Myasthenia Gravis refers to a chronic autoimmune neuromuscular disorder characterized by varying degrees of weakness in voluntary muscles. Know more about Myasthenia Gravis symptoms, causes, diagnosis, and treatment process here.
Nivedita Dar29 Apr, 2024
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Myasthenia Gravis is an autoimmune disorder caused by disruption of communication between nerve cells and body muscles. It may result in muscle weakness that increases with activity. The primary symptoms include double vision, drooping eyelids, weakness of the arm or leg muscles, and difficulty speaking, chewing, swallowing, and even breathing. Medications and other treatments can produce effective results.
What is Myasthenia Gravis?
The neuromuscular condition known as myasthenia gravis (MG) results in weakness in the skeletal muscles, which are utilized for movements. There is a breakdown in the nerve-muscle connection, and as a result, important muscle contractions cease to happen. Typically, this disease affects the muscles in your neck, arms, legs, and eyes. It may impair your capacity to perform the following activities:- Blink or move the eyes.
- Keep your eyes open
- Facial movements and expressions
- Swallow, chew, and speak
- Raise your arms and pick up things.
- Using a staircase or getting up from seating
Symptoms of Myasthenia Gravis
The primary manifestation of myasthenia gravis is weakness in the voluntary skeletal muscles. The degree of weakness may vary, and the severity of the symptoms usually worsens with activity and gets better with rest. If muscles are unable to react to nerve impulses, they usually cannot contract, which generates various symptoms. Individuals with MG may experience symptoms that impact different parts of the body, as mentioned below.Eyes
- Drooping of the eyelid (ptosis)
- Blurred or double vision (diplopia)
- problems moving the eyes and eyelids
Face
- Facial paralysis
- Problems with chewing
- Changes in facial expressions
Throat
- Speaking difficulties (dysarthria)
- Problems with swallowing
- Difficulties in chewing
- Voice hoarseness
- Weakness in the neck makes it difficult to hold the head up.
Arms and Legs
- Severe weakness
- Lack of strength in arms, hands, and fingers
- Fatigue in the legs from climbing stairs or quick movements
Chest
- Breathlessness
- Breathing difficulties
- Muscle weakness in the chest
Causes of Myasthenia Gravis
A combination of thymus gland issues and erratic antibody production might be the causes of manifestations of myasthenia gravis. Some of the potential causes and risk factors are as follows:Autoimmune Reaction
When your immune system unintentionally targets healthy tissue, autoimmune diseases can result. These antibodies often target nerve cells, causing MG to occur.Thymus Gland Problem
In MG patients, the thymus gland remains enlarged. It is also possible to develop benign or malignant tumors of the thymus gland.Age
Myasthenia gravis is prevalent in men who are older than 60 years, while women can acquire this problem before the age of 40. Around 15% of MG cases start in childhood.Diagnosis of Myasthenia Gravis
In addition to reviewing your medical history and symptoms, your healthcare professional will perform a physical examination to diagnose the disease. The different tests conducted in this regard are as follows:Neurological Tests
- Examining the reflexes of the body
- Looking for muscle weakness
- Checking for muscle response
- Examining eye movements
- Checking sensations in different parts of the body
Blood Analysis
Blood tests are conducted to check for the presence of any unusual antibodies that block the nerve's response to stimulate the muscle.Repetitive Nerve Stimulation
In this test, the nerve is put through multiple tests to check its ability to convey impulses to muscles. The test's results contribute to the diagnosis of MG.Single-Fiber Electromyography (EMG)
This test measures the electrical activity that travels from your brain to your muscles.Imaging
An MRI or CT scan can help determine the presence of any tumor or other issue with your thymus.Pulmonary Function Test
These tests determine whether the disease is causing breathing problems.Botulism: A Diagnostic Concern for Myasthenia Gravis
One of the main diagnostic concerns while examining for myasthenia gravis is suspected botulism disorder. The majority of botulism patients initially report the same symptoms as MG, which include muscle dysfunction and weakness, difficulty in vision and speech, trouble swallowing, etc. In extreme cases, it leads to tongue weakness, partial face distortion, and a lack of strength in the limbs. The source of botulism is botulinum toxin. The type of botulism differs according to the source of the toxins. The generation of local toxins is a risk for both adults and infants who suffer from stomach acid production. Also, wound botulism can occur on the damaged tissues generated by a wound after an injection.Types of Myasthenia Gravis
Myasthenia Gravis can be of different types:- Autoimmune Myasthenia : The most probable reason is the generation of specific antibody subtypes (immune system proteins).
- Congenital myasthenia : This is caused by a genetic mutation and is not an autoimmune disease.
- Neonatal Myasthenia : A fetus receives specific antibodies from the delivering parent, who has myasthenia gravis. Usually, these transient symptoms disappear after three months.
More About Neonatal Transient Myasthenia Gravis
Babies born to mothers with Myasthenia Gravis (MG), including those with little or no disease symptoms, are usually affected by this special type of disease known as neonatal transient myasthenia gravis. During pregnancy, the placenta has the potential to transmit the mother's antibodies to her fetus, which would destroy the acetylcholine receptors. Mothers with MG are more likely to transmit this active disease to their children. The risk and severity of this disorder are connected to greater levels of maternal autoantibodies in the mother.Treatments for Myasthenia Gravis
Different forms of treatment, either in combination or separately, can address myasthenia gravis symptoms. Doctors will determine the treatment strategies based on your age, the severity of your condition, and the outcomes achieved. The primary therapies include the following:- Medications: Some drugs have the ability to reduce MG symptoms.
- Monoclonal antibodies : biologically designed proteins are infused intravenously (IV) or subcutaneously (SQ) to suppress the hyperactive immune system and damage nerve cells.
- Plasma exchange (plasmapheresis): Dangerous antibodies are extracted from the blood plasma and replaced with donor plasma or a plasma solution.
- Intravenous immune globulin (IVIG): It is an infusion of healthy donors' antibodies through intravenous procedures. It minimizes the effect of the antibodies that cause myasthenia gravis and provides short-term relief.
- Surgery: The removal of the thymus gland by surgery (thymectomy) may be recommended in certain cases.
Myasthenia Gravis FAQs
What is the myasthenic crisis?
One of the most hazardous forms of MG is a myasthenic crisis, which causes acute muscle weakness that could result in respiratory failure.
How does myasthenia gravis affect the thymus gland?
In some adults with myasthenia gravis, the thymus gland is larger than normal, and some may also have thymus gland tumors.
What type of diet is suitable for people affected by myasthenia gravis?
A person with MG needs to eat a diet rich in protein and carbohydrates that provides added energy.
Is exercise recommended during myasthenia gravis?
It is highly advised to exercise within your limitations. Take brief breaks in between, and avoid working out if you feel weak.
How long does myasthenia gravis last?
Myasthenia gravis affects people for a long time, as there is no permanent cure. However, early detection and treatment can manage its symptoms.
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