What’ Up Doc?: Treatment can control symptoms of myasthenia gravis
By DR. NOORALI BHARWANI on March 15, 2022.
Recently, I was talking to a lady who told me she has been diagnosed with myasthenia gravis. Myasthenia gravis is a chronic autoimmune disorder that can affect people of any age. It is more common in women younger than 40 and in men older than 60. It can occur at any age but is most common in adults. It is not inherited. The condition affects the voluntary muscles of the body, especially those that control the eyes, mouth, throat and limbs. Myasthenia means muscular weakness. Gravis means the condition is more virulent than average. The illness causes weakness of the skeletal muscles. This happens because there is breakdown in the normal communication between nerves and muscles. Nerves’ ability to control muscle activity is weakened or lost. Normally, the immune system functions well, fighting infection and other foreign invaders to the body. But it also mistakenly attacks some of the body’s own tissue. In this case it attacks the neuromuscular junction, where nerve endings release chemical transmitters that stimulate the muscle to contract. Myasthenia gravis is a disease of fluctuating weakness. The symptoms can range from mild to severe. In some cases, symptoms are so minimal that no treatment is necessary. Even in moderately severe cases, with treatment, most people can continue to work and live independently. Quite often the symptoms get worse with repeated use and improve with rest. In most people with this condition, muscle weakness is temporary and reversible, and tends to wax and wane over time. It is not a progressive disease but the symptoms come and go. The muscles that control the eyelids and movement of the eyes are most commonly affected, although the disease does not lead to loss of eyesight. In about 10% of myasthenia gravis cases, only the eye muscles are affected. In most people, however, symptoms start in the eyes then spread to other muscles, which can include those that control speech, chewing, swallowing or breathing, or those of the neck, trunk or limbs. The effects of myasthenia gravis tend to vary over time. The disease is often directly affected by a person’s general health, including physical condition, sleep patterns, hormonal changes, other diseases, medications and even emotional state. Stress and lack of rest are common culprits in aggravating myasthenia gravis symptoms. Maintaining a healthy lifestyle is key to managing the disorder. There is no cure for myasthenia gravis, but treatment can provide some relief. Treatment with medications can correct the defective communication between nerves and muscles, thus improving strength. Fortunately, current treatments control symptoms very effectively, and the outlook for a long and productive life is excellent for the majority of patients. About 10% of people with myasthenia gravis have a tumour of the thymus gland (located behind the breastbone) that should be surgically removed. In some people who have generalized disease, removing the thymus gland may reduce disease activity or trigger remission. Life expectancy for myasthenia gravis patients is normal except in rare cases. Good news about myasthenia gravis is it can go into remission lasting for several years. Most people with myasthenia gravis are able to gain muscle strength through medication or immunotherapy. Dr. Bharwani is a general surgeon, freelance writer, photographer and author of A Doctor’s Journey and Doctor B’s Eight Steps to Wellness. His books are available at http://www.nbharwani.com. You can discuss this article and other articles on his website: nbharwani.com and sign up for RSS feed, Twitter or get on the email list. 13-12
