Myopathy and Myasthenia gravis

MYOPATHY AND MYASTHENIA GRAVIS

Overview

Myopathy is a neuromuscular disorder in which the muscle fibers do not function properly. The common myopathy symptoms are muscle weakness, muscle pain and tenderness, muscle cramps, fatigue, lack of energy. There are numerous myopathy causes and each has its own specific name, cause, diagnostic tests and treatment. However, there are no effective myopathy treatment that can cure myopathy. The myasthenia gravis symptoms can be improved or can be prevented from worsening. 

Myasthenia gravis is a autoimmune disease which occurs due to the weakening of skeletal muscles. The neuromuscular disorder occurs due to the impaired communication between nerve and muscle cells. It prevents the muscle contraction and thus causes muscle weakness.   

What are the symptoms of myasthenia gravis?

The major myasthenia gravis symptoms is voluntary skeletal muscle weakness. Without the proper response to nerve impulses, muscle contraction fails and thus muscle weakens. Some of the common symptoms of MG are: 

  • Problem in talking
  • Difficulty stepping the stairs or lifting weights
  • facial paralysis
  • Problem in breathing due to weak muscles
  • Trouble in swallowing or chewing
  • Weakness & tiredness
  • Droopy eyelids
  • Double Vision
The symptoms vary in different individuals but the muscle weakens over time. Also, the symptoms get worse with exertion and improves with rest.

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What causes myasthenia gravis?

The myopathy causes is still unclear. According to some researchers, when immune system attack healthy tissue autoimmune disorders occur. Antibodies mistakenly attack the neuromuscular junction instead of attacking foreign, harmful substances in the body. The damaged neuromuscular membrane reduces the effect of neurotransmitter substance acetylcholine which causes the muscle weakness. 

How is myasthenia gravis diagnosed?

The doctor will do a complete physical exam and enquire about the detailed history of the symptoms. They’ll also perform a neurological exam that consist of:
  • checking the reflexes
  • Identifying muscle weakness
  • Checking of muscle tone
  • test sensation in different areas of the body
  • checking motor functions
Few other tests that can help the doctor to know about the condition are:
  • repetitive nerve stimulation test
  • blood test for antibodies linked with MG
  • edrophonium (Tensilon) test
  • CT Scan for chest imaging or MRI to check for tumor

Treatment options for myasthenia gravis

Myasthenia gravis treatment involves managing the symptoms and controlling the activity of immune system.

Medication
There are corticosteroids and immunosuppressants that can be used to suppress the immune system. These can help to reduce the abnormal immune response which occurs in MG.

In addition, cholinesterase inhibitors such as pyridostigmine (Mestinon) can enhance the communication between nerves and muscles.

Thymus gland removal

Thymus gland removal in patients with MG reduces muscle weakness. According to the Myasthenia Gravis Foundation of America, about 10 -15 percent of people with MG develop a tumor in their thymus. The removal is the appropriate solution as it may become cancerous. 

Plasma exchange

The process involves the removal of harmful antibodies from the blood which causes muscle weakness. Removing the harmful antibodies result in an improvement in muscle strength.Plasma exchange is beneficial before surgery or during extreme muscle weakness.

Intravenous immune globulin

The blood product Intravenous immune globulin (IVIG) is used to treat autoimmune MG.

Lifestyle changes

Following few lifestyle changes can help reduce Myasthenia gravis symptoms :

Taking adequate rest helps to minimize muscle weakness.

Avoid stress and heat exposure as they can worsen symptoms.

Though these myasthenia gravis treatment cannot cure MG. However, they can simply improve the symptoms. Make sure to check with your doctor before taking any type of medication.

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