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Myasthenia Gravis Awareness

06/10/21

Myasthenia gravis (MG) is an autoimmune disease that causes periods of muscle weakness. It works by keeping your nerves from passing signals to your muscles.

Myasthenia gravis happens most often in women ages 20 to 40, and men ages 50 to 80, but it can happen at any age. The most common form of MG is a chronic, autoimmune, neuromuscular disorder characterized by fluctuating weakness of the voluntary muscle groups.

In the U.S., it is estimated that 20 in 100,000 people have MG or approximately 36,000 to 60,000 cases. However, as myasthenia gravis often remains underdiagnosed, the prevalence is most likely higher.

What causes myasthenia gravis?

MG results from abnormal immune system activity. Individuals with other auto-immune diseases or an abnormal thymus gland are more likely to have MG. Physicians suspect there may be a combination of factors that trigger the onset of MG symptoms in a susceptible individual, such as an infection or other illness.

Generally, MG is not considered an inherited disease. However, if one family member has an autoimmune disease, it’s not unusual for other family members to also have an autoimmune disease. It is possible for a mother to pass a temporary form of MG to her newborn child. On rare occasions, the disease does occur in multiple family members.

What are the symptoms of myasthenia gravis?

  • weakness of the eye muscles (called ocular myasthenia)
  • drooping of one or both eyelids (ptosis)
  • blurred or double vision (diplopia)
  • a change in facial expression
  • difficulty swallowing
  • shortness of breath
  • impaired speech (dysarthria)

What are the treatment options for myasthenia gravis?

Various treatments, alone or in combination, can relieve symptoms of myasthenia gravis. Your treatment will depend on your age, how severe your disease is, and how fast it's progressing.

Medications

  • Certain medications enhance communication between nerves and muscles. These medications aren't a cure, but they can improve muscle contraction and muscle strength in some people.
  • Corticosteroids such as prednisone inhibit the immune system, limiting antibody production.
  • Immunosuppressants are drugs to depress the immune system allowing muscles to work better. This treatment can take months to work and might be used with corticosteroids.

Intravenous therapy

  • Plasmapheresis. This procedure uses a filtering process similar to dialysis. The good effects usually last only a few weeks, and repeated procedures can lead to difficulty accessing veins for the treatment.
  • Intravenous immunoglobulin. This therapy provides your body with normal antibodies, which alters your immune system response. Benefits are usually seen in less than a week and can last three to six weeks.
  • Monoclonal antibody. These drugs are usually used for people who don't respond to other treatments.

Surgery

  • Some people with myasthenia gravis have a tumor in their thymus gland. If you have a tumor, called a thymoma, doctors can surgically remove your thymus gland (thymectomy).
  • Even if you don't have a tumor in the thymus gland, removing the gland might improve your myasthenia gravis symptoms.

What is the prognosis with MG?

Many people with MG can live fairly normal lives. The first one to three years – when various symptoms appear – often are the most difficult. It can take time to work through various treatment options to find what works best. However, there is no way to predict if you’ll achieve remission or how long it will last.

How do I find a doctor who treats MG?

Myasthenia gravis is a neuromuscular disease, so it’s best to see a neurologist for treatment. For more information and a referral to a specialist, contact your primary healthcare provider. If you do not have a primary care provider, contact CCMH Medical Clinic at 712-265-2700 to see a Family Medicine Provider who can help you find a specialist.