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Myasthenia Gravis: Symptoms and Treatment

Abhijit Naik
A short write-up on myasthenia gravis, a chronic disease characterized by long periods of fatigue and muscular weakness, with emphasis on its symptoms and treatment.
Myasthenia gravis, also abbreviated as MG, is an autoimmune disorder which is typically characterized by tiring and weakening of muscles. A person suffering from this condition may experience weak muscles without getting involved in any sort of physical activity. Approximately 200 - 400 individuals in a million suffer from this disorder.

Causes

This neuromuscular disease is caused when the antibodies block acetylcholine receptors at post-synaptic neuromuscular junction and suppress the stimulative effect of the neurotransmitter acetylcholine―the chemical that directs muscles by sending signals through an area known as the receptor.
In case of myasthenia gravis, the number of acetylcholine receptors goes below the amount necessary. In autoimmune diseases, antibodies misidentify a part of the body as a foreign invader and attack it. In this case, the antibodies mistake acetylcholine, which is essential for muscle contraction, as a foreign object and destroy it.

Symptoms

  • Experiencing fatigue and weakening of the muscle group, for a short period, due to continuous use.
  • Ptosis: Sagging of the upper eyelid due to muscle paralysis and weakness.
  • Diplopia: Visual impairment in which an object appears as two objects.
  • Dysphagia: A condition in which swallowing food becomes difficult.
  • Facing difficulty in breathing.

Diagnosis

If any of the above symptoms of myasthenia gravis are noticed, further diagnosis is advised. This will include physical examination, such as lifting your arms out at the shoulder level to check the muscle strength, and blood test to determine the presence of acetylcholine-receptor antibodies.
In course of diagnosis, medication (e.g. edrophonium) will be administered to enhance the strength of the muscles for a short period, thus confirming the disease. CT scan and MRI may be performed to check for thymoma. Blood tests will be done to check for diabetes or any kidney problems in the patient, as these problems may lead to further complications.

Treatment

Myasthenia gravis can be treated by medication and surgery. The patient will be treated with a dose of pyridostigmine to increase the amount of acetylcholine in the body. Immunosuppressant drugs, like azathioprine and cyclophosphamide, will be given to decelerate the production of antibodies that harm acetylcholine.
An individual with severe myasthenia gravis will be subjected to plasmapheresis―a process wherein plasma containing antibodies is replaced by antibody-free plasma.
An immunoglobulin preparation, which acts as an antibody, will be injected into the veins. If the patient is suffering from thymoma, the thymus will be surgically removed. It is wise to consult a certified medical practitioner if the patient experiences difficulty in breathing. If the condition occurs in cases of severe infection, the patient will be treated with antibiotics.
It is possible to prevent myasthenia gravis by taking some simple precautions. Healthy living is the foremost priority. Infections, if any, should be treated at the earliest. Though very rare, this disease can lead to many complications, and hence, is best avoided.