Myasthenia gravis is an autoimmune condition that can make your muscles weak and may become worse with activity and improves with the rest. It happens due to a lack of communication between the nerves and muscles.
Overview
There is no cure for this condition, but the treatment can help a person who is suffering from myasthenia gravis to ease the symptoms. People with this condition may feel pain whenever they use their muscles and also often result in muscle weakness. Based on health authorities, this condition became the most common disorder in the United States. People who are between the ages of fourteen and twenty are more likely to develop this condition.
This condition has its effects on all ages of the people, but particularly women who are below the age of forty and men who are above sixty years have a higher risk of getting diagnosed with this condition. People may unable to speak if this disease affects to their throat muscles and it will be difficult for them hewing anything and experience difficulty in swallowing. This condition can also cause your neck, arms, and legs muscles weak.
What are the indicators of this condition?
The most common symptoms associated with myasthenia gravis is going to be a weakness in the voluntary skeletal muscles. It means the muscles which will be under your control will be affected by this disease. As they are unable to contact the impulses of the nerves, it often leads to muscle failure and becomes difficult to contract.
Double vision, unable to speak, drooping of eyelids, unable to walk upstairs or difficult to lift objects, hoarse voice, facial paralysis, exhaustiveness, difficulty in breathing or unable to breathe due to the weakness of the muscle, and difficulty swallowing or difficult to chewing are considered as the most common symptoms associated with myasthenia gravis.
What are the causes of myasthenia gravis?
There can be a variety of causes that can include and this is very important to keep in mind. This condition is considered an autoimmune disorder. It is likely to develop when a person’s body tissues attacked by the same person’s immune system.
The immune system function is to kill the unwanted invaders which are present in the body. These includes
- Bacteria
- Toxins
- Viruses
A person who is suffering from an autoimmune disease will be attacked by the antibodies which are present in the human blood. These antibodies try to destroy healthy tissues and cells by mistake. When it comes to the person who is suffering from the myasthenia gravis, the same antibodies will make the availability of a few muscle fibers as they kill the muscle receptor cells. Due to this conflict between the antibodies and the healthy cells, it will be difficult for the muscle to contract properly and it will make the muscles very tired and weak.
The thymus gland plays a vital role in this process which is located in the upper chest beneath and even experts don’t know why this happens. This gland will start to grow when a person is in an infant stage and gradually increases until their puberty. After reaching this stage, the growth of this gland will stop automatically and it gets replaced by the fat. It has been observed in research that one in ten people who are suffering from myasthenia gravis also have an underlying medical condition known as a benign tumor that is present in the thymus gland. There are many medications that can cause this condition. The following are the medications that can trigger the condition. These triggers include
- Beta-blockers
- Quinine
- Antibiotics
- Calcium channel blockers
People who have this condition shouldn’t feel stress as it can worsen the symptoms like high temperature and tiredness. This condition may affect newborn babies also if they got from their mothers and when an infant is diagnosed with this condition is called Neonatal myasthenia. Children may get relief from the symptoms of this condition in two to three months after taking the proper care. This condition affects the children and infants very rarely.
Have a word with your physician
When a person is experiencing difficulties in taking breathing, and also unable to swallow and chewing, then it is better for the person who is suffering from this condition should have a word with their health care provider. If you are unable to use your arm muscles or unable to see or experience the symptoms of myasthenia gravis then it is better to speak with your physician about what’s going on and they can review with you about your family history and help you to determine what options are best for you.
What are the complications of myasthenia gravis?
There are also a variety of complications but these are treatable, but sometimes the same complications can be life-threatening. The following are the complications that can be caused by this condition. These complications include
- Myasthenic crisis
- Thymus gland tumors
Myasthenic crisis
People are likely to experience this life-threatening condition when they suffered from myasthenic gravis. This condition occurs when a person’s muscles that can control breathing are unable to perform their duties. Myasthenic crisis needed an emergency treatment otherwise the patient life will be at risk if he or she doesn’t receive the treatment at a proper time. Affected persons will breathe again not on their own but with the mechanical assistance. There are also a variety of medications that can help a person to breathe again on their own.
Thymus gland tumors
It has been observed in research that one in ten people who are suffering from myasthenia gravis also have an underlying medical condition known as a benign tumor which is present in the thymus gland and these tumors are called thymus gland tumors. These tumors are not cancerous and not life-threatening.
How to diagnose this condition?
In order to diagnose the condition, your physician may ask some questions which are related to your symptoms and also recommend some tests. The following are the tests that can be performed by the physician to confirm myasthenia gravia. These tests include
- Imaging tests
- Pulmonary function tests
- Single-fiber electromyography (EMG)
- Blood analysis
- Neurological examination
Imaging tests
An imaging test may be a computed tomography scan or magnetic resonance imaging. These tests used to check the tumor in the thymus gland.
Pulmonary function tests
This test is conducted to know whether the myasthenia gravia is causing the person any breathing problems.
Single-fiber electromyography (EMG)
This test is used to measure the electrical activity that is happening between the brain and the muscle. A fine wire electrode is inserted into your muscle through the skin and it will test the single muscle fiber.
Blood analysis
Blood tests can provide necessary information to the doctors and it reveals the antibodies which are causing damage to the receptor sites.
Neurological Examination
In this examination, the physician tests the person’s muscle strength, balance, coordination, reflexes, muscle tone, and senses of touch and sight.
How is myasthenia gravia treated?
There are treatments for this condition which can include lifestyle alternations, non-prescription options as well as prescription medications. The main objective of any form of treatment is to provide relief from the symptoms of this condition.
Thymus gland removal
When there is no medication that works for the patient, then the removal of the thymus gland through surgery is the best option for you. Once it is removed, the patient will no longer feel muscle weakness. It has been observed in research that fifteen percent of the people who are suffering from myasthenia gravis also have an underlying medical condition known as a benign tumor which is present in the thymus gland.
Plasma exchange
The main objective of plasma exchange is to destroy the harmful antibodies which are present in the blood and this process is also known as plasmapheresis. It is a short-term treatment and the harmful antibodies will still continuously produced by the body during this procedure.
Intravenous immune globulin
This treatment is used to treat autoimmune myasthenia gravia and the blood will be collected by a donor to start this procedure.
Medications
There are a variety of medications that can be used to treat this condition. These medications include
- Cholinesterase inhibitors
- Corticosteroids
- Immunosuppressants
Let’s discuss the above medications in detail.
Cholinesterase inhibitors
The main objective of these medications is to improve communication between the nerves and muscles. Examples of these medications include Mestinon, Regonal, and bloxiverz. These drugs are not a complete cure to this condition but can enhance muscle contraction and strengthen the muscles. The following are the possible side effects associated with these medications. These medications include
- Gastrointestinal upset
- Nausea
- Excessive sweat
- Excessive salvation
- Diarrhea
Corticosteroids
Corticosteroids limits the production of antibodies and inhibit the immune system. Prednisone is an example of corticosteroids. The following are the possible side effects associated with corticosteroids. These side effects include
- Bone thinning
- Diabetes
- Overweight
Immunosuppressants
Your physician may recommend you to take immunosuppressants as these medications have the capability of changing the immune system. Examples of these drugs include azathioprine, CellCept, Sandimmune, and trexall. The following are the possible side effects associated with these medications. These side effects include
- Liver damage
- Kidney damage
- Increased risk of infections
Conclusion
The risk of developing this condition increases as people grow older and detecting the early signs of this condition is very important and it can limit disease progression in people. Some people may show mild symptoms but it is better for the person who is suffering from the symptoms of myasthenia gravis to talk with the physician about what’s going on and they can review with you about your symptoms and help you to determine which treatment option is suitable for you.
References
- https://www.ncbi.nlm.nih.gov/pubmed/32395290
- https://www.ncbi.nlm.nih.gov/pubmed/32395166
- https://www.ncbi.nlm.nih.gov/pubmed/32388060
Sirisha B 
Raju Ch