Written By: Debjani Arora | Updated : April 15, 2015 3:34 PM IST
We hardly pay attention to the voluntary movements of our body. We seldom think that anything can go wrong with any of the mundane tasks that we do with our body. But there is a possibility of the same, especially if your muscles become too worn out to perform the action. This is a medical condition called myasthenia gravis.
What is myasthenia gravis?
Myasthenia gravis is a chronic autoimmune disorder that affects the voluntary muscles of the body. It is characterized by weakness or rapid muscle fatigue. The condition is supposed to occur when there is a dysfunction between the muscles and the nerves that control the same. A defect in the transmission of nerve impulses to the muscles gives rise to the symptoms of the condition.
Myasthenia gravis is usually not inherited but it develops with age. It often affects women after the age of 40 and men after 60. Muscle weakness is a common symptom of many other conditions and hence a diagnosis for myasthenia gravis is often delayed and learnt about quite late.
What causes myasthenia gravis?
The probable causes of myasthenia gravis are as follows:
Nerve-and-muscle transmission defect: The nerves that control the muscles release chemicals called neurotransmitters which are accepted by the receptors of the muscles. These neurotransmitters send signals to the muscles to work in accordance. With a condition like myasthenia gravis, the immune system of the body produces antibodies that destroy or block the receptors in the muscle. With lesser receptors the muscles receive lesser signals from the nerves. This results in muscle weakness and fatigue.
Thymus gland malfunctioning: The thymus gland is present on the chest area right beneath the breastbone. It is believed that this gland contributes a lot in the development of the body's immune system. Usually during infancy the gland is large in size and reduces as one grows and the immune system of the body develops. But with people suffering from myasthenia gravis, the thymus is usually large. Though it is not clear how a large thymus gives rise to the condition but experts believe that an abnormal thymus can send improper signals to the immune cells to develop antibodies that block the muscle receptors.
Genetic factors: In some very rare cases genetic factors can be associated with the condition. Sometimes some people are born with a rare form of the condition called as congenital myasthenia syndrome. If a mother suffering from the condition gives birth to a baby with the same, the condition is usually treatable within two months after birth.
What are the symptoms of myasthenia gravis?
Muscle weakness due to myasthenia gravis can be fluctuating. The reason being with adequate rest the muscles regain some of their vigour. But repeated usage of the same muscles can lead to worsening of the symptoms and the condition. The muscles of the body which are most affected due to the condition are -- the muscles of the eye lid, neck and limb, face and throat among others. The common symptoms of the condition are:
What complications can arise if the condition goes unnoticed?
A condition like myasthenia gravis can lead to complications like
How is the condition diagnosed?
A diagnosis of the condition is done in the following way:
Physical examination: The doctor might ask you to do certain movements to check on the reflexes, muscle strength, muscle tone, coordination and balance.
Blood test: A blood test might be done to check for the antibodies available in the body that blocks the receptors of the muscles.
Edrophonium test: In this test injections are given to check if the muscles gain their strength with insertion of the chemical edrophonium chloride. This might result in a sudden, although temporary, improvement in the muscle strength. This is an indication that you may have myasthenia gravis.
Electromyography (EMG): Though a bit uncomfortable, this test involves insertion of a thin electrode to through the skin to the affected muscle to measure the electrical activity between the brain and the muscles
Imaging scan: A CT scan or MRI might be done to check if there is a tumor or other abnormality in the thymus.
Pulmonary function tests: Certain pulmonary function tests are done to check if the condition has been affecting the breathing.
How is myasthenia gravis treated?
There is no cure for the condition but with proper treatment the condition can be managed effectively. Following are the treatment options for the same:
Medications: Cholinesterase inhibitors are prescribed to enhance the communication between the nerves and the muscles, improve muscle contraction and strength. The side effects of the drug include gastrointestinal upset, nausea, and excessive salivation and sweating. Corticosteroids are at times given to limit the antibody production. They too can give rise to side effects with prolonged use like weight gain, diabetes and infections. Sometimes immunosuppressants are given to suppress the production of antibodies. Their side effects can include liver and kidney damage.
Surgeries: For people who have tumors developed in the thymus gland a surgical removal of the same is suggested. At times the surgery is suggested to sufferers without having the tumors also to alter the symptoms of the condition. Surgery is usually the last resort of the treatment.
Living with myasthenia gravis
Certain lifestyle changes might become necessary
Plan your day: If you are taking medications, your symptoms might wax and wane during the day. So finish your chores while you feel little better. Remember rest can always help you regain enough muscle strength so keep some time blocked for rest too.
Be regular with your medications: Because cure is not an option adhere to your medications for symptom relief.
Be careful while walking: Use the sidewalks or pavements when you walk on the roads. At home keep minimal furniture and less clutter to make movement easy and avoid accidents.
Use electronic appliances: Simple tools can make your life easy and give your muscles enough rest. Like using a coffee maker, a dough maker etc can make it easier for you to work while exerting your muscles less.
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