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Myasthenia Gravis – Pictures, Causes, Symptoms, Treatment

Updated on January 28, 2014

Myasthenia gravis is an autoimmune disorder that affects the muscles and nerves. Persons who have this condition suffer from chronic muscle weakness which worsens during physical exertion and improves after ample rest. This neurological autoimmune disease primarily influences the voluntary muscles, such as those involved in facial expressions, talking, chewing, eye movement and limb motions. As such, this disorder is typically manifested by drooping eyelids, changes in facial expressions, difficulties in feeding, shortness of breath, and weakness in the neck and extremities to name a few.

About Myasthenia Gravis

Myasthenia gravis or MG is an autoimmune condition that affects the communication between the muscles and nerves. The term is coined from Latin and Greek words that translate to “grave muscle weakness.” The skeletal muscles or voluntary muscles are affected by this neuromuscular disorder. This condition is manifested differently in each case, but the most widespread is the chronic type which is typified by varying degrees of weakness of the muscles.

Myasthenia gravis does not discriminate as it affects both males and females from any race and at any age. MG is believed to occur in more than 20 out of a hundred thousand people since many cases may have gone undiagnosed.

What are the causes of Myasthenia Gravis?

MG disrupts the transmission of signals from the nerves to the voluntary muscles. During normal conditions, the communication or nerve signals travel through the nerves. Acetylcholine, a substance released by the nerve endings, carries the signal from the neuromuscular junction and connects with the receptors which will then translate the communication into muscle contraction.

In the case of MG, the immune system produces antibodies that hinder the acetylcholine receptors from functioning normally. These receptors are obstructed, modified or destroyed, thus preventing the correct communication from reaching the muscles. As a consequence, no muscle action happens and muscle weakness is exhibited. With MG, as much as 80% of the receptor sites are disabled.

What are the signs and symptoms of Myasthenia Gravis?

Myasthenia gravis most commonly affects muscles that control the facial expressions, eyelids and eyes as well as swallowing. However, all skeletal muscles are susceptible to this condition. This autoimmune disorder first shows itself in the eye muscles. Uncontrolled eye movement and drooping eyelids are some of the first signs. In other individuals affected by MG, the early signs are garbled speech and problems in swallowing. The onset of the condition can be abrupt that it is not easily diagnosed as myasthenia gravis.

The severity of the condition differs from one individual to another. Some patients of MG suffer from severe muscle weakness that affects a significant number of muscles, whereas others only have problems with a specific group of muscles, such as the eye muscles.

Some of the signs and symptoms of myasthenia gravis are as follows:

  • Drooping eyelids

  • Double vision or blurred vision

  • unbalanced gait

  • alteration in the facial expression

  • problems in swallowing

  • difficulty breathing

  • dysarthria (problems in speaking)

  • weakness in the neck, arms, fingers and legs

How is Myasthenia Gravis diagnosed and treated?

Since muscle weakness is a symptom of many different medical conditions, the diagnosis of Myasthenia gravis could be difficult. The doctor would assess the symptoms presented and study the patient’s medical history. If he or she suspects MG, the case may be referred to a neurologist who will order for additional tests or diagnostic procedures to confirm the condition.

If MG is confirmed, treatment methods that could help address the symptoms will be recommended. There is no cure for this neuromuscular autoimmune disorder but steps could be done to help alleviate muscle weakness and manage the symptoms.

The following are the treatment methods that may be employed for myasthenia gravis:

  • Rest

In mild cases, ample rest to reduce muscle weakness is sufficient to address the problem.

  • Drugs

Medications to improve communication between the nerves and muscles such as pyridostigmine and neostigmine are used to stimulate muscle contraction. Prednisolone and other steroids, on the other hand, are prescribed if the symptoms still aggravate even with the use of pyridostigmine. In addition, immunosuppressants like azathioprine and mycophenolate are prescribed to control the immune system from producing antibodies that attack the acetylcholine receptors.

  • Thymectomy

This is the surgical procedure to remove the abnormal thymus gland which often improves the condition of individuals with MG. However, improvement is slow taking between one to three years before significant results are seen.

  • Immunoglobulin therapy and plasmapherisis

These are applicable for very severe cases only wherein the patient’s life is in danger due to breathing and swallowing problems. Even so, the effects of these procedures are short term, lasting a few weeks only.

Individuals affected with myasthenia gravis suffer from varying degrees of difficulty. Some need only to rest to improve muscle weakness, whereas others need additional treatment methods to deal with the symptoms. In the past, MG is considered a grave disease, but advancements in medicine have allowed most MG patients to live almost normal lives.


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