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Autoimmune Diseases - Myasthenia Gravis

 
     
 

 

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Understanding Myasthenia Gravis

Myasthenia gravis is a chronic disorder, which results in muscular weakness, especially after the muscle has been exercised; the degree of weakness varies from person to person. It is an autoimmune disease (a disorder in which the body reacts to its own tissues as though they were foreign proteins), which breaks the linkage between the nervous system’s stimulation of a muscle and the muscle’s response.

Symptoms and manifestations
Symptoms and manifestations are quite individualized. Every person may have his or her set of problems. A person may have severe breathing problems but he may be mobile. On the contrary, he may be immobile but totally free of breathing difficulties.

 

A person affected by myasthenia gravis may have difficulty in climbing stairs or rising from chairs. Simple actions like lifting things or raising his arms over his head may be tests of strength for him. His speech may begin to sound nasal, since all the lower facial muscles may be involved. Usually, the muscles that are first affected are those concerned with eye movements, facial expressions, chewing, swallowing and respiration. The person may have to support his chin with one hand in order that he may be able to talk. There could be double vision, drooping eyelids and eye wandering. 

From the face, the disease spreads to the neck, trunk and limb muscles. Weakness in the neck may be mild or severe. It can be so severe that the person may have difficulty holding his head erect. The heart usually remains unaffected. The person may have respiratory problems. Respiratory arrest may happen in very severe cases. 

What happens is that the muscles first fail to contract after prolonged use. They appear to become weaker with repeated mild activities but seemingly regain strength after rest. Eventually, muscular paralysis may result, with degeneration of muscle fibers and infiltration of lymph cells.

When can it occur?
Myasthenia gravis can occur at any age. However, it is rare that it sets in before age ten or after age seventy. Usually women are more prone to it than men and it has been noted that the condition is more prevalent in some families. Some symptoms may set in suddenly, while some symptoms may remain in a person for twenty years or so without any marked worsening. The latter is true in the case of visual problems such as double vision and drooping eyelids.

Treatment
Since myasthenia gravis is an autoimmune disorder where the linkage between stimulus and response is broken, treatment includes drugs that stimulate the transmission of nerve impulses. In very severe cases, surgery is advised for removal of the thymus, if there is thyroid tumor. Although death may result from sudden respiratory arrest, myasthenia gravis is not a fatal disease.

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