Living with a condition that affects your muscle strength can be overwhelming, especially when everyday tasks become unexpectedly difficult. Myasthenia Gravis is one such condition, where simple actions like keeping your eyes open, swallowing, or even taking a deep breath can feel like a challenge. The good news is that with the right understanding, treatments, and support, many people with this condition can manage their symptoms and lead fulfilling lives. We spoke to our expert Dr Pavan Pai, Consultant Interventional Neurologist, Wockhardt Hospitals, Mira Road, Mumbai, who explained what causes this condition, how it presents, and the steps to regain control.
What is Myasthenia Gravis?
“Myasthenia Gravis is a chronic autoimmune neuromuscular disorder that primarily affects the skeletal muscles responsible for voluntary movements. In this condition, the body’s immune system mistakenly targets the communication between nerves and muscles, leading to muscle weakness,” said Dr Pai. This weakness typically worsens with activity and improves with rest, creating a unique pattern of symptoms.
According to StatPearls, Myasthenia gravis, like many autoimmune conditions, arises in individuals with a genetic predisposition, triggered by external or internal factors. These triggers can include infections, immunisations, surgeries, and certain medications. Notably, childhood-onset of this disease is relatively rare in Western populations but shows a higher prevalence in Asian countries, affecting nearly half of patients under the age of 15.
Also Read: Myasthenia Gravis: When should one seek medical advice?
Symptoms of Myasthenia Gravis
It is characterised by muscle weakness, which is variable in severity and presentation. Here are some commonly affected areas as listed by the expert:
- Eye muscles: Drooping eyelids (ptosis) and double vision (diplopia) are often early signs.
- Facial and throat muscles: Difficulty speaking (dysarthria), swallowing (dysphagia), or chewing food can occur.
- Limbs and neck: Weakness in arms, legs, or neck muscles may make it challenging to perform everyday tasks like climbing stairs or holding up one’s head.
- Breathing muscles: In severe cases, respiratory weakness can lead to life-threatening complications, requiring immediate medical attention.
Causes and Risk Factors of Myasthenia Gravis
The exact cause of Myasthenia Gravis is not fully understood, but the condition is linked to an immune system malfunction. “The immune system creates antibodies that interfere with or destroy the receptors for acetylcholine, a neurotransmitter vital for muscle contraction,” added Dr Pai. Several factors can increase the risk of developing this disease, including:
- A background of other autoimmune conditions, like rheumatoid arthritis or lupus.
- Thyroid disorders.
- Certain medications that interfere with nerve-muscle communication.
- Infections that may trigger or exacerbate symptoms.
Potential Complications of Myasthenia Gravis
Living with Myasthenia Gravis can present numerous challenges. Chronic muscle weakness may lead to:
- Fatigue: Persistent tiredness can interfere with daily activities and reduce the quality of life.
- Mental health issues: Anxiety and depression are common among people managing the condition, often due to its unpredictable nature.
- Myasthenic crisis: This severe complication involves sudden muscle weakness that affects breathing, requiring urgent medical care.
Diagnosis of Myasthenia Gravis
Diagnosing Myasthenia Gravis involves a combination of clinical evaluation and diagnostic tests.Dr Pai listed the common methods as follows:
- Physical examination: A doctor assesses muscle strength and fatigability
- Blood tests: These detect the presence of specific antibodies associated with this disease
- Nerve stimulation tests: These measure electrical signals in muscles to evaluate nerve-muscle communication
- Imaging studies: CT scans or MRIs of the neck and chest are used to check for an enlarged thymus gland, often associated with Myasthenia Gravis
Treatment Options For Myasthenia Gravis
Although there is no permanent cure for Myasthenia Gravis, several treatments can effectively manage its symptoms and improve quality of life. Here are some treatment plans listed by Dr Pai:
- Medications: Drugs like acetylcholinesterase inhibitors improve nerve-muscle communication, while immunosuppressants help reduce abnormal immune responses.
- Plasmapheresis and Intravenous Immunoglobulin (IVIG): These therapies remove or neutralise harmful antibodies during severe episodes.
- Surgery: In cases where the thymus gland is enlarged, a thymectomy (surgical removal of the gland) may be recommended.
Living with Myasthenia Gravis
Managing Myasthenia Gravis requires a combination of medical treatment and lifestyle adjustments. Here are some tips to improve daily living:
- Exercise wisely: Engage in light, doctor-approved exercises to strengthen muscles without overexertion.
- Follow a balanced diet: A protein-rich diet can provide the necessary nutrients for muscle health.
- Rest when needed: Listening to your body and avoiding overexertion can help prevent symptom flare-ups.
- Build a support system: Connect with healthcare professionals, support groups, and loved ones for emotional and practical assistance.
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issues to avoid complications.]