Maneuver Away From Myasthenia Gravis

You have droopy eyelids and see double vision. You have muscle weakness in your limbs. Recently you have developed some difficulty with swallowing. You could have myasthenia gravis.

Myasthenia gravis is a long-term disease that adversely affects the skeletal muscles. These are the muscles that, with the help of tendons and ligaments, make it possible for the body to move and perform a wide range of functions.

Skeletal muscles are known as voluntary muscles, which means they are under a person’s direct control. Myasthenia gravis does not affect the involuntary muscles, such as the heart, or those that line the blood vessels, organs, stomach and intestines. When someone has myasthenia gravis, their skeletal muscles become weak and quickly grow fatigued when in use.

The name of the disease is drawn from Greek and Latin and means grave or serious muscle weakness. The condition is caused by a glitch in the immune system that mistakenly blocks the pathways of communication between the muscles and the nerves that animate them. Taken together, and in more scientific terms, myasthenia gravis is a chronic neuromuscular autoimmune disease.

Symptoms include droopy eyelids, weakness in the eye muscles, difficulty swallowing, impaired speech, difficulty breathing, and weakness in the neck, arms, hands, fingers or legs. Since each case is different, symptoms vary in type and intensity. Some individuals have mild disease in which treatment isn’t necessary. In severe cases, weakness in the muscles of the chest and diaphragm impairs the ability to breathe effectively. This is known as myasthenic crisis, and it is a medical emergency.

The disease can occur at any age, but is frequently seen in young women in their 20s and 30s and men aged 50 and older. There is no cure for myasthenia gravis.

A diagnosis of myasthenia gravis is based on the patient’s symptoms and the results of a variety of tests. Physicians order blood tests to look for specific antibodies that interfere with communication between the nerves and muscles. They also can measure the electrical activity in muscles with a test called an electromyogram.

Some patients may have abnormalities in a gland called the thymus, which can be identified with a CT scan.

Experts estimate that 150 to 200 per 1 million people worldwide have myasthenia gravis, according to the Healthline website. Researchers speculate that there may be 30,000 to 60,000 people living with myasthenia gravis in the United States.

Autoimmune conditions are those in which the immune system responds inappropriately, targeting the person’s own body. In the case of myasthenia gravis, the immune system produces antibodies that block or destroy certain critical protein structures on the person’s muscles that are called receptors.

These receptors are designed to receive a type of nerve signal (neurotransmitter) called acetylcholine. When the receptors are blocked, the signal doesn’t go through, resulting in weakness.

In some people with myasthenia gravis, other antibodies and proteins may be involved.

The condition does not appear to have a genetic component, and it is not clear what triggers it.

It is like a short circuit, with the result that the immune system no longer recognizes these muscle receptors as a part of the self.

This disease is highly treatable. Thanks to modern advances in treatment, people can live a normal life span. It is very rare for a patient to die from this condition.

Myasthenia gravis is typically treated with medicines called anticholinesterases. Doctors may also prescribe steroids or other drugs that suppress the immune system’s response.

In some cases, surgeons may alleviate symptoms by removing the thymus, though the role of that gland in myasthenia gravis is not fully understood.

Patients who have trouble breathing should seek emergency care. In severe cases, they may be placed on a ventilator. Physicians then can pump the person’s blood through a device that filters out the problematic antibodies, and they generally recover the ability to breathe on their own.