Myasthenia Gravis

Myasthenia gravis (MG) is an autoimmune disorder that causes weakness that can affect vision, facial muscles, chewing, swallowing, arm and leg strength, and breathing.  In MG, the body’s immune system makes antibodies against receptors on the muscles that allow the nerves to tell them to contract.  When these receptors are blocked, people will experience weakness.  MG can present in a variety of ways.  For this reason, it is often called the “snowflake” disease because every person that gets it is so different than the other.  The diagnosis is often made with a simple blood test to look for these antibodies.  In some instances, electrodiagnostic testing may need to be done.  Treatment consists of medication to help the nerves talk to the muscles better or medications to suppress the immune system from producing these antibodies.

Spectrum Health is a Myasthenia Gravis Partners in Care Site.

For more information about MG, visit: Myasthenia Gravis Foundation of America

Local support group:  MG-MI

 


Treatments for Myasthenia Gravis

Myasthenia gravis is an autoimmune neuromuscular disease. Effective treatments are available and most people with myasthenia gravis live normal lives. Once your best treatment response is found, you may be symptom-free for long periods of time. Early diagnosis and treatment can make a big difference.

Our goal with treatment is to restore muscle function and prevent swallowing and breathing problems. Typically, daily medicine is all that's needed. Sometimes, respiratory or nutritional support may be needed.

Electromyography and Nerve Conduction Studies
Electromyography and nerve conduction studies, typically referred as an EMG, are electrical tests of muscle and nerve that neurologists and physiatrists perform on patients for a variety of conditions.

Immune Suppressing Medicine
Medicine to suppress the immune system (steroids) can reduce the body's attack on the neuromuscular system. This can also successfully reduce muscle fatigue. Prednisone is an example of a steroid you may be prescribed.

Immunoglobulin Procedure
Given intravenously, this blood product helps decrease the immune system attacking the nervous symptom.

Muscle and Nerve Biopsy
A muscle biopsy is a procedure used to identify an infection or disease in your muscle.

Neuro Rehabilitation
Our physical therapy and rehabilitation experts don't just work on improving your physical function. We understand that neurological connections with your brain and your nerves affect your physical, cognitive and emotional health. Our holistic approach brings you greater success.

Plasmapheresis 
Through blood donation, this transfusion replaces abnormal antibodies in the blood with normal antibodies.

Skin Biopsy
Your doctor may request a skin biopsy, which is a sample size of skin tissue is removed for testing for suspicious areas of skin that are abnormal in size, color and shape.

Thymectomy Surgery
This surgical procedure removes the thymus gland. It may or may not improve symptoms, but has been linked to altering the immune system's response.

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What Is Myasthenia Gravis (MG)?

Myasthenia gravis (MG) is an illness that causes muscles in the eyes, face, throat, arms, and legs to get weak and tired. Muscles that control breathing may also be affected. The worst weakness usually occurs during the first 3 years.

MG affects people of both sexes, all ages, and all ethnic groups. Women usually get MG in the late teens and 20s, and men usually get it after age 60. Progression of MG is extremely slow and most people lead full lives.

What Causes MG?

MG is an autoimmune disease. This means that the body’s immune system attacks itself. MG isn’t contagious or passed from parents to children. MG is more common in people with tumors of the thymus gland called thymoma. The thymus gland is located in the chest and is part of the immune system.

What Are the Symptoms of MG?

Symptoms may get better (remission) and then worsen (exacerbation). The time between remission and exacerbation varies. The major symptom is muscle weakness that gets worse when people are more active. Temperature, menstrual periods, illness, and stress can affect the weakness. Other symptoms are eye problems (double vision, droopy eyelids); problems chewing, speaking, or swallowing; drooling; and arm and leg weakness. One symptom, shortness of breath, can be very frightening.

How Is MG Diagnosed?

The health care provider will make a diagnosis from a complete physical examination, with tests of lungs, reflexes, and muscle weakness. A specialist may do more tests, including electromyography, Tensilon® test, blood test, and computed tomography (CT). Electromyography measures muscle electrical activity as they contract after nerve stimulation. In the Tensilon® test, medicine temporarily improves muscle strength in people with MG. CT will check for a tumor or enlargement of the thymus gland.

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How Is MG Treated?

The treatment depends on how severe symptoms are, age, sex, and physical activity level. Medicines such as steroids and anticholinesterase drugs can help symptoms. Lifestyle changes such as eating a good diet and getting enough rest can also help. Rest briefly during the day (about 10 to 15 minutes), and avoid strenuous work that may make fatigue worse. Try to exercise daily, as advised by the health care provider and physical therapist. For double or blurred vision, see an eye health care provider, and don’t drive or use heavy equipment. If swallowing is a problem, try foods of different consistency to find out which is best. Often thin liquids such as juice and water are harder to swallow than thick ones. Manage stress better. Regular exercise may help with stress management. Avoid smoke and dust.

DOs and DON’Ts in Managing MG:
  • DO try to find a balance between rest and physical activity to prevent muscle weakness.
  • DO get physical therapy to keep muscles strong.
  • DO wear a medical alert bracelet or necklace that says you have myasthenia gravis.
  • DO take medicines as prescribed. Call your health care provider if you have problems with your medicines.
  • DO call your health care provider if you have shortness of breath or your symptoms worsen to include double vision, blurred vision, or weakness.
  • DON’T gain weight and become inactive.
  • DON’T use tobacco. It may worsen shortness of breath.
FOR MORE INFORMATION

Contact the following source:

  • Myasthenia Gravis Foundation of America
    Tel: (651)917-6256, (800)541-5454
    Website: http://www.myasthenia.org
  • American Academy of Neurology
    Website: http://www.neurology.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc

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