June is Myasthenia Gravis Awareness Month

June is Myasthenia Gravis Awareness

I know I have the body of a weak and feeble woman, but I have the heart and stomach of a king, and of a king of England too.  ~Elizabeth I

Myasthenia Gravis

Awareness ribbon is the color teal.

Myasthenia means a condition causing abnormal weakness of certain muscles.

Gravis means “serious.”

Myasthenia gravis is an autoimmune disease that causes weakness in the muscles under your control. It happens because of a problem in communication between the nerves and muscles. The body’s own immune system makes antibodies that block or change some of the nerve signals to the muscles. This makes the muscles weaker.

What is Myasthenia Gravis? #myastheniagravis #mg #autoimmune

Who is affected:

Myasthenia gravis affects both men and women and occurs across all racial and ethnic groups.  It most commonly impacts young adult women (under 40) and older men (over 60), but it can occur at any age, including childhood.  Myasthenia gravis is not inherited nor is it contagious.  Occasionally, the disease may occur in more than one member of the same family.

Common symptoms are:

  • Muscular: muscle weakness or weakness of the arms and legs
  • Facial: drooping of upper eyelid or muscle weakness
  • Also common: difficulty swallowing, double vision, fatigue, shortness of breath, or impaired voice

Although myasthenia gravis can affect any of the muscles that you control voluntarily, certain muscle groups are more commonly affected than others. Because symptoms usually improve with rest, your muscle weakness may come and go.

Diagnosis

Your doctor may check your neurological health by testing your:

  • Reflexes
  • Muscle strength
  • Muscle tone
  • Senses of touch and sight
  • Coordination
  • Balance

The key sign that points to the possibility of myasthenia gravis is muscle weakness that improves with rest.

Other tests may be used to make a diagnosis:

  • Edrophonium test – used to differentiate myasthenia gravis from cholinergic crisis and Lambert-Eaton.
  • Ice pack test – a useful bedside test that can aid in the differentiation of MG from other conditions. The ice pack test is cheap, safe, and very quick to perform as it can be carried out at the bedside in approximately 3–5 minutes.
  • Blood analysis
  • Repetitive nerve stimulation – nerve to be studied is electrically stimulated six to ten times at 2 or 3 Hertz.
  • Single-fiber electromyography (EMG) – is a selective EMG recording technique that allows identification of action potentials (APs) from individual muscle fibers.
  • Imaging scans
  • Pulmonary function tests

Treatment

Doctors use a variety of treatments, alone or in combination, to relieve symptoms of myasthenia gravis.

Medications

  • Cholinesterase inhibitors – provide relief from symptoms by blocking the action of acetylcholinesterase (An enzyme that breaks down the neurotransmitter acetylcholine at the synaptic cleft (the space between two nerve cells) so the next nerve impulse can be transmitted across the synaptic gap.) and increasing the amount of acetylcholine at the neuromuscular junction.
  • Corticosteroids – are a class of steroid hormones that are produced in the adrenal cortex of vertebrates, as well as the synthetic analogues of these hormones.
  • Immunosuppressants – or anti-rejection medications are drugs that inhibit or prevent activity of the immune system.

Intravenous therapy

  • Plasmapheresis – a method of removing blood plasma from the body by withdrawing blood, separating it into plasma and cells, and transfusing the cells back into the bloodstream. It is performed especially to remove antibodies in treating autoimmune conditions.
  • Intravenous immunoglobulin (IVIg) – is used to treat various autoimmune, infectious, and idiopathic diseases. IVIG is an approved treatment for graft versus host disease and ITP. It is accepted for use in persons with Kawasaki disease, Guillain-Barré syndrome, and polymyositis/dermatomyositis.
  • Monoclonal antibody – an antibody produced by a single clone of cells or cell line and consisting of identical antibody molecules.

Surgery

About 15 percent of the people with myasthenia gravis have a tumor in their thymus gland, a gland under the breastbone that is involved with the immune system. If you have a tumor, called a thymoma, doctors will conduct surgery to remove your thymus gland (thymectomy).

If you don’t have a tumor in the thymus gland, surgery to remove the thymus gland may improve your myasthenia gravis symptoms. It may eliminate your symptoms, and you may be able to stop taking medications for your condition. However, you may not notice the benefits of a thymectomy for several years, if at all.

 

Your doctor will determine which treatment may be most appropriate for you based on several factors, including:

  • Your age
  • Severity of your condition
  • Location of muscles affected
  • Other existing medical conditions

 

If you have myasthenia gravis, it is important to follow your treatment plan.

Source:

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