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Are You Feeling Weak? The Unexpected Causes of Myasthenia Gravis Disease Exposed

Dr Rishika Agarwal 209 Views
Updated: 11 Sep 2024
Published: 11 Sep 2024

Myasthenia gravis (MG), a neuromuscular condition, causes weakness in the skeletal muscles of your body. The breakdown in the nerve-muscle connection that results from myasthenia gravis stops muscle contractions that are necessary for regular movement. This disorder can be managed with proper treatment, and the symptoms range from mild to severe depending on the patient. Symptoms usually peak in intensity one to three years after the disease manifests, but with therapy, the majority of those who have the illness can live an active life. Keep reading to find out more about the symptoms, treatments, and causes of myasthenia gravis disease.  

What is Myasthenia Gravis?

An autoimmune disease called myasthenia gravis results in weakening in the skeletal muscles, which are the muscles that facilitate movement. Myasthenia gravis usually affects the muscles in your neck, arms, legs, and eyes and may impair your capacity to blink, make facial gestures, chew, speak, and move. Muscle weakness increases with exercise and decreases following rest, and in this disease, the symptoms often appear rapidly. Myasthenia gravis is a chronic neuromuscular disease, and even though there isn't a cure, you may control your symptoms and resume normal functioning with treatment. 

Myasthenia gravis has multiple varieties.  

  • Autoimmune myasthenia: In autoimmune myasthenia, the most prevalent kind of MG, the creation of certain antibodies is thought to be the main cause. Autoimmune myasthenia has two types- ocular and generalized. Your eyes' and eyelids' muscles get weaker in ocular MG, and you could find it difficult to keep your eyes open, and your eyelids may droop. The earliest symptom is eye weakness, and for over half of all cases of myasthenia gravis, the ocular form may progress to the generalized form. Your eye muscles, as well as those in your face, neck, arms, legs, and throat, are all impacted by the generalized form. It might be challenging for you to lift your arms over your head, walk, climb stairs, or speak. 
  • Congenital myasthenia: This variety is caused by a genetic mutation and is not an autoimmune disease. 
  • Neonatal myasthenia: Certain antibodies are transferred to the baby from a myasthenia gravis-affected parent.     

What are the Causes of Myasthenia Gravis?

A combination of specific antibodies and thymus gland issues may be the reason why people develop this condition.  

Here are the potential causes of myasthenia gravis disease: 

  1. Thymus gland irregularities

    The thymus gland regulates healthy immune responses. It normally expands until puberty, and then the size of the gland decreases. But, in people with myasthenia gravis, the thymus gland remains big even after they reach adulthood. A large thymus gland generates acetylcholine-blocking antibodies. It is also possible to develop benign or malignant tumors of the thymus gland, which might disrupt the synthesis of essential immune cells. Because of these factors, the thymus gland could send wrong signals to your immune system, which could result in MG.

  2. Autoimmune reaction

    When you have autoimmune diseases, your immune system unintentionally targets healthy cells of your body. Antibodies, which usually target dangerous growth in the body, instead kill nerve cells when you have MG. It's unknown what specifically causes this autoimmune response, but your chance of having an autoimmune illness like MG may be raised by a family history of autoimmune disorders.

  3. Age

    Although myasthenia gravis can strike at any age, females are more likely than males to be diagnosed before the age of 40, while males are more likely to be diagnosed after 60. Ten to fifteen percent of MG cases start in childhood, and newborns may also have a transient illness known as neonatal myasthenia.  

Symptoms of Myasthenia Gravis 

Weakness in the skeletal muscles is one of the most common myasthenia gravis symptoms. If muscles are unable to react to nerve signals, they cannot contract, and weakness arises when the nerve and muscle are unable to communicate. If treatment is not received, the degree of weakness may vary every day, and the severity of the symptoms usually worsens over time. 

These are the common myasthenia gravis symptoms for different body parts:  

  • Eyes: MG can cause drooping eyelids, blurry or double vision, and issues with eye and eyelid movement.  
  • Face: MG may impair your ability to regulate your facial muscles, which may result in facial paralysis, difficulty chewing, and cause changes in your facial expressions. 
  • Chest: When chest muscles are affected by MG, you could feel shortness of breath, and have breathing difficulty. Weakness in the diaphragm is also very common, and respiratory failure may result from these factors.   
  • Throat: When MG impairs the throat muscles, you will have difficulty speaking, swallowing, and chewing. You will also likely have a hoarse voice and neck weakness that can make it problematic to hold up your head.  
  • Limbs: MG might impact the muscles in your arms and legs, which could result in weakness in your fingers, hands, and arms and weakness in your legs. In this case, you will face issues with lifting objects or walking for a prolonged period.  

Myasthenia Gravis Treatment 

Myasthenia gravis has no known treatment that can give you a full cure, but there is effective medicine available to assist with symptom management.   

  1. Medications

    (a) 
    Corticosteroids: A corticosteroid inhibits the immune system and reduces its capacity to create antibodies. However, you need to remember that prolonged use of corticosteroids might have major adverse consequences, including diabetes, weight gain, deteriorating bones, and an increased risk of certain infections.

    (b) Cholinesterase Inhibitors
    : Medication like pyridostigmine enhances nerve-muscle transmission. While these medications don't provide a full cure for MG, they can help muscles contract more forcefully and stronger. Remember that intense salivation and perspiration, diarrhea, nausea, and upset stomach are possible adverse effects.

    (c) Immunosuppressants
    : It is also possible for your doctor to recommend additional medications that alter your immune system, and usually these medications will consist of mycophenolate mofetil, cyclosporine, methotrexate, azathioprine, or tacrolimus. Corticosteroids and these medications, which have a months-long half-life, may be combined in certain cases. Immunosuppressant side effects might include increased infection risk as well as liver or renal damage.

  2. Plasma Exchange (plasmapheresis)
    Antibodies are extracted from your blood plasma by an IV attached to a machine during plasma exchange (plasmapheresis) and replaced with donor plasma or a plasma solution.

  3. IV or SC immunoglobulin (IVIG or SCIG)
    Generalized myasthenia gravis can be treated with IVIG or SCIG, and during this process, you will receive IV infusions containing donor antibodies throughout the treatment course.

  4. Monoclonal antibodies
    You'll have biologically designed proteins infused intravenously (IV) or subcutaneously (SC) in this treatment, and the hyperactive immune system can be suppressed by these proteins.

  5. Surgery
    Surgery is another myasthenia gravis treatment option if the patient has thymus gland tumors. A thymectomy, the removal of the thymus gland, can limit the symptoms of the disease and provide relief.  

Final Remarks

Myasthenia gravis, an autoimmune disease, usually affects the majority of the body and gradually spreads over months or years from the eyes and face to other parts. However, myasthenia gravis can also harm only the eyes of the patient in certain cases. People frequently experience flare-ups when their symptoms become specifically extreme, and then they experience remission when their symptoms become more manageable. If you are suffering from the common symptoms of myasthenia gravis, it is highly recommended that you visit a doctor without delay. The doctor will give you a test to diagnose the condition and promptly start your treatment.  

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