Myasthenia gravis (MG) is an autoimmune disorder that prevents nerve impulses from reaching the muscles at the cellular level. The patient’s own immune system produces antibodies that attach to the skeletal muscle cells and block the neurotransmitters from sending the chemical messages to the nerve cells.
In the beginning stages MG primarily affects the facial muscles that control eye movement, chewing and speaking. The patient may have trouble speaking, chewing, swallowing and as the muscles of the eyes are affected the patient may develop double vision. The patient may become exhausted by the act of chewing while eating.
As time progresses, the patient may experience facial paralysis and drooling may occur. He or she may experience generalized weakness of the extremities, which may completely incapacitate the individual. The disease can also continue to the point that the muscles necessary for breathing become affected.
The Myasthenia Gravis Foundation of America (MGFA) classifies the disease into 5 categories from the least severe to the most severe forms. The least severe form is when the condition is confined to the eye and facial muscles, and the most severe form involves the inability of the patient to eat and breathe on his/her own. The patients that are the most severely affected by the disease require life support to maintain respiration and nutrition.
In the beginning symptoms can be so subtle that MG may be difficult to diagnose. It usually isn’t until the patient has more severe symptoms that take him/her to the doctor that the doctor will suspect the diagnosis of Myasthenia gravis. The symptoms of the disease may be exacerbated by continued stress, a respiratory infection-such as pneumonia-as well as other factors including pregnancy. Approximately 30 percent of the patients with MG improve without treatment, while others are treated medically or surgically.
Diagnosis is made by a thorough examination which will include a test called an electromyogram (EMG) that records the electrical activity within the muscle fibers. When muscles receive impulses from nerve cells they become active and produce an electrical current.
When treated medically MG is usually treated with prednisone or some other steroid designed to suppress the immune system from attacking the nerve/muscle communication. Some patients will require a surgical removal of the Thymus gland, which is located in the upper chest just beneath the breast bone. This gland produces a type of white blood cell-called a T-cell-which governs immunity within the cells of the body. Removal of this gland will lessen the need for medication to suppress the immune system, or it will take the symptoms away completely.
Should you recognize any changes in yourself that resemble any of these signs and symptoms mentioned here, you should see your doctor for an evaluation. The most significant change you may notice about yourself is that your jaws get tired while eating. When you rest for a while, you will feel better and resume eating. Other symptoms involving the facial muscles may present as time progresses, followed by visual problems.
It is important to recognize these changes when they happen, and if they continue to see your doctor, and not ignore these symptoms. Most people can live to a normal life expectancy, barring any complications.
