Myasthenia Gravis: Symptoms, Causes, and Treatment

Introduction:

Myasthenia gravis is an autoimmune disorder caused by an error in communication between nerve cells and muscles. It results in muscle weakness in voluntary muscles, most often in the muscles of the eyes, face, neck, and arms. Myasthenia gravis affects approximately 1 in 5,000 people in the United States, although specific ethnic populations, such as Ashkenazi Jews, are more prone to developing the condition. This condition affects women twice as much as men.

Causes of Myasthenia Gravis:

Myasthenia gravis is caused by a deficiency or malfunction of acetylcholine, a neurotransmitter essential to the functioning of muscles. When the levels of acetylcholine decrease, nerve signals are insufficient to activate muscle contractions resulting in muscle fatigue and weakness in voluntary muscle groups. The cause of this disorder is unknown, although research has found autoantibodies, created by the body’s immune system, have attacked acetylcholine receptors resulting in the disease.

Symptoms of Myasthenia Gravis:

Myasthenia gravis symptoms often vary from person to person. Common disorder symptoms include difficulty speaking, blurred vision, and difficulty chewing, drinking, and swallowing, though some individuals with myasthenia gravis do not experience these symptoms. Some patients may also experience weakness in their arms, legs, or diaphragm muscles. In severe cases, those with myasthenia gravis can have difficulty breathing.

Diagnosis of Myasthenia Gravis:

The diagnosis of myasthenia gravis is usually straightforward and is made through a medical history and a physical exam.
Blood tests are also used to measure levels of acetylcholine and autoantibodies. Other imaging tests, such as an MRI or CT scan, may be performed to look for structural abnormalities. There is no cure for myasthenia gravis. However, treatment is available that can improve the condition significantly.
Treatment includes medications such as acetylcholinesterase inhibitors, which help the smooth muscle of the eyes and muscles around the diaphragm, and immunosuppressive drugs that can stop the production of the autoantibodies attacking the acetylcholine receptors. Plasmapheresis, or blood-filtering, is also used to reduce levels of autoantibodies in the blood. Surgeries may improve symptoms and include thymectomy, the surgical removal of the thymus gland, where the autoantibodies are thought to form. In some cases, physical and occupational therapy may help manage myasthenia gravis. Therapy can help to build muscle strength or help to control symptoms such as difficulty with speech, eating, and swallowing. Psychological therapy can also help patients cope with the effects of the condition.

In Summary:

Myasthenia gravis is a chronic condition that can cause disability in some patients. Management of the disease typically includes a combination of medications, food, lifestyle changes, physical and occupational therapy, and psychological therapy.