MYASTHENIA GRAVIS

MYASTHENIA GRAVIS:

Introduction:

  • Myasthenia Gravis is a neuromuscular disorder that causes weakness in the skeletal muscles, which are the muscles our body uses for movement.
  • This disease is characterized by variable degrees of weakness of the skeletal muscles.
  •  It occurs when communication between nerve cells and muscles becomes impaired. This impairment prevents crucial muscle contractions from occurring; which results in muscle weakness.

                                        

  • According to the National Institute of Health, MG occurs in people over the age of 40. Womens are more likely to be diagnosed as younger adults, whereas men are more likely to be diagnosed at the age of 60 or older.
  • Myasthenia Gravis is the most common primary disorder of neuromuscular transmission.
  • It is relatively rare condition that affects between 14 and 20 out of every 100,000 people in the U.S.

Causes:

  1. Myasthenia Gravis is caused by an autoimmune disorder which can occur when our immune system mistakenly attacks healthy tissue. In this condition, antibodies are proteins that normally attack foreign, harmful substances in the body, which attacks the neuromuscular junction. Damage to the neuromuscular membrane reduces the effect of the neurotransmitter substances acetylcholine; it’s a chemical substance for the communication between nerve cells and muscles. This results in muscle weakness.  
  2. It is resulted by a defect in the transmission of nerve impulses to muscles.
  3. It is caused by the breakdown in the normal communication between nerves and muscles.
  4. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction; the place where nerve cells connect with the muscles, they control.

                    

Symptoms:

  1. Weakness in the voluntary skeletal muscles. Failure in these muscles to contract normally occurs because they cannot respond to nerve impulse. The communication between nerve and muscles is blocked due to the lacking of proper transmission which results in weakness.
  2. Weakness in myasthenia gravis gets more worsens with more physical activity and improves with rest.
  3. Patient may feel difficulty in talking.
  4. There is problem in walking upstairs or lifting the objects.
  5. Patient may suffer facial paralysis.
  6. There is difficulty in breathing due to muscle weakness.
  7. Difficulty in swallowing or chewing.
  8. Fatigue
  9. Drooping of eyelids
  10. Double vision
  11. Hoarse voice

Although Myasthenia gravis could affect any of the voluntary muscles, certain muscles are more commonly affected than others; some of them are;

  1. Eye Muscles: Dropping of one or both eyelids, Double vision
  2. Face and Throat muscles: Altered speaking, Difficulty in swallowing, problem in chewing, limited facial expressions.

Diagnosis:

  1. Checking for muscle tone.
  2. Checking reflexes
  3. Looking for the muscle weakness.
  4. Testing sensation of different parts of our body.
  5. Testing motor functions like; touching fingers to nose.
  6. Checking movements of eye.
  7. Repetitive nerve stimulation test.
  8. Blood testing for antibodies which are associated with Myasthenia gravis.
  9. Endrophorium (tensilon) test; in this test a drug named tensilon is administered intravenously and we have to do our muscle movement under doctor observation.
  10. Imaging of the chest using Computed Tomography (CT) scans or MRI to rule out a tumor.

Treatment:

There is no any particular treatment for this disease. It occurs when the immune system malfunction and attack the body’s tissues. The goal of treatment is to manage the symptoms and control the activity of immune system through the following:

  • By proper medications
  • Removal of thyroid gland
  • Plasma exchange
  • Intravenous immune globulins
  • Lifestyle change
  • Rest; to minimize muscle weakness
  • Avoid stress and heat exposure

Medication:

Coticosteroids and Immuno-suppressants can be used to suppress the immune system. These medications help minimize the abnormal immune response that occurs in MG.

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