Myasthenia Gravis: An Overview

Myasthenia Gravis in Latin and Greek is for "grave muscle weakness". As this implies, the condition is a chronic autoimmune neuromuscular disease that involves weakness of the skeletal muscles of the body. It's good to know that it's not as "grave" as you'd first think since there have been various advancements in therapies and medications for this condition. But it still helps to know more about this.

Symptoms
• Most Common Signs
Some symptoms can come and go but they usually progress over time.
For about half of the people who suffer from this problem, the first signs would include:
- eye problems including drooping of one or both eyelids (ptosis)
- double vision of either horizontal or vertical

• Next Common Signs
About 15 percent of people with myasthenia gravis experience difficulties with the face and throat muscles.
These would include:
- altered speaking
- difficulty swallowing
- problems with chewing
- limited facial expressions

• Other Signs
In some people, the ailment can bring about weakness in the neck, arms and legs.

• Severe Signs
It's vital to see the doctor immediately if you have problems with:
- breathing
- seeing
- swallowing
- chewing
- walking
- holding up your head
- using the limbs

Causes
• Neurotransmitters
In a healthy person, the nerves communicate with the muscles through the chemicals called neurotransmitters that fit into the muscle cells' receptor sites. If you have this condition, your immune system produces antibodies that destroy those receptor sites. When there are fewer receptor sites available, the muscles are only able to catch few messages from the nerves. The result is significantly weaker muscles.

• Thymus Gland
Some medical experts believe that the thymus gland, which is a part of the immune system that can be found beneath the breastbone, can trigger the production of the antibodies that destroy the receptor sites. The theory is supported by findings that some adults with myasthenia gravis have an abnormally large thymus or tumors in this gland. Factors that can aggravate this condition include illness, fatigue, stress and extreme heat.

Treatments
Doctors use various treatments for this condition.

• Cholinesterase
Cholinesterase inhibitors are prescribed to improve the communication between the nerves and muscles. While these drugs don't cure the disease, they enhance muscle strength and contraction.

Some side effects are:
- excessive salivation
- frequent urination
- gastrointestinal problems

• Corticosteroids
Corticosteroids, which suppress the immune system, inhibit the production of the antibodies. It's important to know however the long-term use can cause serious side effects like:
- weight gain
- diabetes
- infections
- bone thinning

• Other Medications
Other medications that inhibit the function of the immune system may also be prescribed, including:
- azathioprine (Imuran)
- cyclosporine (Sandimmune, Neoral)
- mycophenolate (CellCept)

Like the corticosteroids, these medications put you at higher risk of infection. Apart from that, they also increase risk of:
- infertility
- liver damage
- cancer

• Therapies
- Plasmapheresis
Plasmapheresis is a filtering process of the blood that removes the antibodies that destroy receptor sites

- Intravenous Immune Globulin
This is a process of ingesting normal antibodies to change the response of the immune system

• Surgery
Surgery might be performed to remove the tumor in the thymus.

 


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