Myasthenia Gravis

Myasthenia Gravis is a skeletal muscle weakness disorder. It is a neuromuscular disease that affects mostly the facial muscles like eyes and mouth. It causes an individual affected by it, to have droopy mouth and eyelids and they tend to have a double vision. Myasthenia Gravis also results in the person to walk unsteadily. This disorder is caused by a process of the breakdown in the regular communication between the muscles and nerves that allows an individual to actively move their skeletal muscles.

Symptoms

The symptoms of Myasthenia Gravis are very evident and can be clearly seen on an individual. If an individual is suffering from the following symptoms, then they probably have the Myasthenia Gravis disorder:

-  Extreme fatigue

-  Hoarse voice

-  Paralysis in the facial muscles

-  Doubling up of the vision

-  Weakening of the muscles

-  Experiencing trouble in talking

-  Experiencing problems in lifting any objects

-  Problems in regular breathing

-  Not being able to chew properly

-  The dropping of the person’s eyelids

-  Not being able to walk up the stairs properly

-  Difficulty in the activity of swallowing

What happens when the disease strikes?

The Myasthenia Gravis disorder affects the facial muscles as well as the throat muscles in quite a few of the individuals suffering from it. The neck muscles and the muscles in the limbs are also affected.

- Speech alteration: According to the affected muscles, the speech of an individual would either sound nasal or very soft.

- Swallowing difficulty: If an individual suffering from Myasthenia Gravis intakes any fluids or liquids, it may result in the liquid flowing out of their nose. An individual might also choke very easily which is why taking in beverages, food and oral medication might become a task or nearly impossible.

- Chewing difficulty: If the individual is having their meal, the Myasthenia Gravis might result in the muscles that help in chewing to wear off in between. This happens more in case they are chewing on food that is hard.

- Expressing: The individuals who are suffering from Myasthenia Gravis find it difficult to express through face what they are feeling. They might become expressionless or might not be able to show a wide range of expressions that humans usually do.

- Muscle weakness: Mostly, in Myasthenia Gravis, the individuals are affected by the muscles of their face, throat as well as eyes. But, the individuals suffering from Myasthenia Gravis also experience weakness in their body parts like the ones in the arms, neck and legs.

Causes

There are certain conditions in a human body that gives rise to the causes of Myasthenia Gravis. They are as follows:

- Genetic conditions: An individual might be at a higher risk of getting the Myasthenia Gravis disorder if were born while their mothers were suffering from the disease. Though it is a rare condition genetic factors might be a cause. The hereditary Myasthenia Gravis is known as Congenital Myasthenia Syndrome. When treated, the infants recover within a short span of 2 months.

- Thymus Gland: The blockage of the Acetylcholine causes an individual to get Myasthenia Gravis. The thymus gland that is a part of the immune system in a human body might trigger the process of production of antibodies; these antibodies are responsible for the blocking of the Acetylcholine. Some individuals who have Myasthenia Gravis also have tumours in their thymus gland, called Thymomas. These tumours are not cancerous.

- Antibodies: The immune system produces antibodies which cause the blockage or destruction of an individual’s muscle receptor sites for a neurotransmitter, acetylcholine. There are fewer receptor sites that result in the muscles of an individual receiving lesser nerve signals. This causes weakness in the muscles that is Myasthenia Gravis.

- Age and Sex factor: The Myasthenia Gravis mostly occurs in individuals over the age of 40 years.

Women: The disorder is known to occur in women in their early ages, mostly when they are younger adults.

Men: This disorder is known to occur in men mostly after they have passed the age of 60 years.

- Autoimmune disorder: Usually, when an individual suffers from an autoimmune disorder, their immune system attacks the healthy tissues, by mistake; this causes the individual to develop Myasthenia Gravis. How it happens is that the antibodies that are responsible for the attack on any foreign substances, attack the neuromuscular junction. The communication between the muscles and cells is affected by the damage to the neuromuscular membrane. This results in muscle weakness.

Prevention

There is no said method of prevention of the Myasthenia Gravis disorder but there can be certain practices or ailments that can be avoided as they might be harmful to the individuals suffering from the disease. Avoiding the following can help:

-  Do not expose your body to temperatures that are extreme to handle

-  Ailment and illnesses such as pneumonia, respiratory infections and tooth abscess

-  Try to avoid getting fevers by taking care of your body

-  Try not to get emotionally stressed

-  Avoid the intake of medicines like muscle relaxants, anticonvulsants and certain kind of antibiotics.

-  Avoid hypokalemia.
- Hypokalemia: Low potassium levels in the body.
The low level is caused by vomiting frequently, diuretics, etc.

-  Do not expose your body to temperatures that are extreme to handle

-  Do not overexert yourself

How is it diagnosed?

A series of the physical examination is carried out by the doctor. Along with this, the individual’s entire symptoms that they have been having are taken into consideration. And, a neurological examination is also taken place.

- Motor functions test: Motor functions are tested through the process of small tests like touching your nose with your finger, etc.

- Eye examination: The person’s eyes are made to move in certain ways to determine the problem

-  The doctor will look for any muscle weaknesses

-  The person’s reflexes will be checked

-  Bodily sensations are checked for in various areas and body parts

-  The muscle tone is checked

Apart from these physical examinations, there are certain medical tests that are also carried out. They are as follows:

- Scans: Scans used for the imaging of the chest such as CT scans are carried out. MRI scans are also carried out to test for any tumours that the individual might have.

- Blood test: Blood tests are carried out to find any antibodies that are associated with Myasthenia Gravis

- Edrophonium Test or Tensilon Test: The process of this test includes the drug, Tensilon, to be administered intravenously into the body and then the individual is asked to perform certain muscle movements which are observed for any irregularities.

-  Repetitive Nerve Stimulation Test

Treatment

There is no cure for the Myasthenia Gravis disorder. It can only be treated in order to better the condition. Myasthenia Gravis is treated in a way to control the person’s immunity system activity.

- Intravenous Immune Globulin: The Intravenous Immune Globulin is abbreviated as IVIG. It is a blood product that is given by donors. The Intravenous Immune Globulin is used to treat autoimmune Myasthenia Gravis. The way it works is that it affects the functioning of the antibodies.

- Removal of Thymus Gland: Individuals suffering from the Myasthenia Gravis disease can go through a procedure of Thymus Gland Removal. The thymus gland is a part of the immune system of a human body. This allows the individual to have a reduced muscle weakness.

In addition to this, the thymus gland removal also results in the removal of a tumour in case the Myasthenia Gravis caused a person to develop it. This eliminates the effects of a tumour on the person.

- Consult doctor: Letting your doctor know about any medicines that are consumed will help them determine if those medicines have any chemical components that can worsen the symptoms or effects of the Myasthenia Gravis disorder.

- Medication: Medications are available that help in the suppression of the immune system by minimizing the irregular immune response. Medicines like Immunosuppressant and Corticosteroids are prescribed to individuals suffering from Myasthenia Gravis. Medicines such as Pyridostigmine (Mestinon) which is a cholinesterase inhibitor that helps to increase the communication between the muscles and the nerves are also prescribed to individuals who have the disorder.

- Making certain changes in lifestyle: Exposure to heat and taking a lot of stress can just worsen the symptoms; so avoid these to reduce the effects. Consulting a doctor about wearing an eye - patch to avoid double vision can be a good step to reduce the effects of the disorder. Getting plenty of sleep and rest will result in the minimization of the weakness in the muscles.

- Plasma Exchange: Plasma exchange is the process of the removal of harmful antibodies from the bloodstream of an individual suffering from Myasthenia Gravis.  Plasma exchange is also known as Plasmapheresis. This process could result in the increment of muscular strength of an individual. It is a short-term treatment that reduces the weakness of the muscles caused by the production of harmful antibodies that disrupt the muscular strength resulting in Myasthenia Gravis with extreme weakness.

Complications

Several complications accompany the Myasthenia Gravis disorder that can have severe effects on a human body. Following are the complications:

- Myasthenic Crisis: A myasthenic crisis occurs when the Myasthenia gravis weakens an individual’s muscles that allow them to breathe normally. These are life-threatening muscle problems that cause a person to gain difficulty in breathing, have problems in swallowing food, drinks and pills. This might cause the death of the person suffering from the disorder. If a person shows signs of any of the above, they should immediately be rushed to the emergency ward.

- Thyroid: Overactive or underactive Myasthenia Gravis might cause an overactive or underactive thyroid in the individuals suffering from it. In case the thyroid is overactive, the individual can experience difficulties in weight loss, dealing with heat and multiple other complications. In case the thyroid is underactive, the individual can experience difficulties in gaining weight, dealing with cold and other issues.

- Thymus Tumor: Research says that about 15 % of the people who have the Myasthenia Gravis disorder have a tumour in their thymus. The thymus is an immune system gland which is present under the breastbone of the human body. A tumour that develops in the Thymus is known as Thymomas. Though these tumours are not malignant, they can severely affect the individual.

- Other diseases: Individuals, who have the Myasthenia Gravis disorder, have higher chances of developing other diseases that are autoimmune. They might be at a higher risk of getting autoimmune diseases such as rheumatoid arthritis or lupus.

Myths

Myth #1: They do not seem like they have Myasthenia Gravis

Individuals suffering from the disease might not always have the symptoms that show their disorder. Remission happens in this disorder but it does not mean that the individual is cured.

Myth #2: What is remission?
Remission is the temporary diminution of a disease, symptom or severity of the said disease.

Myth #3: Exercising will help

Physical therapy does help. But, regular exercising might leave the individuals suffering from the Myasthenia Gravis disorder more than exhausted. They might get exhausted just by performing daily simple tasks.

Myth #4: They do not look sick

Looking sick and being sick are completely different things. The internal pain is much worse than what you can see externally. The internal weakness of the muscles completely exhausts the individuals suffering from the disease. It is very ignorant to not accept someone’s condition just because they do not “look” like they suffer.

Myth #5: They are just lazy to move

No! Myasthenia Gravis causes a person to lose the functioning of their limbs resulting in them needing assistance to complete basic tasks.

Conclusion

Getting more than enough rest and sleep can help an individual with the condition to relax their muscles. Do not shy away from asking for help. If you have anyone you know that has the condition, try to help them as much as possible as they get exhausted very easily because of their weak muscles.

Last updated on : 14-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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