Myasthenia Gravis is the weakening of the body’s muscles due to disorders of the nerves and muscles. In the beginning, patients with myasthenia Gravis will feel tired after a physical activity, but complaints will improve over the rest.
Nerve and muscular disorders are caused by autoimmune, which is the condition when the body’s immune system (antibodies) even attack the body itself. Myasthenia Gravis can be experienced by anyone, but this condition is more often experienced by women aged 20-30 years and men over the age of 50 years.
When not getting treatment, the weakening of the muscles in patients with long Myasthenia Gravis will deteriorate and cause the sufferer to be difficult to move, talk, Swallow, and even breathe.
Myasthenia Gravis Causes
The exact cause of an autoimmune reaction or cell antibodies that attack acetylcholine receptors is not yet known. But in most patients, damage to the thymus gland becomes the cause. So most sufferers will undergo thymus surgery. But once the thymus is removed, there is also no guarantee that this autoimmune disease will heal.
Risk factors of Myasthenia Gravis
Autoimmune
Until now it is still not known exactly what is the exact cause of Myasthenia Gravis. However, the disease is suspected to be related to autoimmune disorders and thymus glands. Disorders that occur in the nerve signals towards this muscle are suspected to be caused by an autoimmune condition.
Autoimmune itself is a condition when a person’s immune system experiences abnormalities. As a result, this immune system will attack healthy tissues and nerves in the body. Well, this autoimmune condition is suspected to affect two things, namely the delivery of nerve signals and thymus glands.
4 Other Risk Factors
Besides autoimmune, Myasthenia Gravis can also be triggered by several factors. E.g:
- Have a father or mother who has a Myasthenia Gravis.
- Have a contagious disease.
- It has unshrinking thymus glands, as in normal people.
- In the treatment of heart and high blood pressure.
It is important to avoid the risk factors of this disease.
Myasthenia Gravis Symptoms
The main symptom of MG is weakness in skeletal muscle, which is muscle under control. Contraction of muscle failure usually occurs because it is unable to respond to nerve impulses. Without a proper impulse transmission, the communication between nerves and muscles is blocked and results of weakness.
The weakness associated with MG worsened more and more active and improved with rest. In most cases, MG often affects muscle face parts, compared to skeletal muscle limb.
Symptoms of MG include
- The difficulty of speaking,
- The problem of climbing stairs or lifting objects,
- Facial paralysis,
- Difficulty breathing due to muscle weakness of breathing,
- Difficulty swallowing or chewing,
- Fatigue,
- Hoarseness.
- Eyelids difficult to open,
- Double vision.
Not everyone has any symptoms, and the level of muscle weakest may change from day to day. The severity of symptoms usually increases over time if not addressed.
Myasthenia Gravis Diagnosis
The doctor will do a physical examination, and see the medical history through symptoms. The doctor will also do a nerve test, with:
- Check reflexes
- Finding the location of muscle weakness
- Examining muscle tone
- Ensure the eyes move normally and naturally
- Examining sensations in different areas of the body
- Examine motor functions, such as touching hands on the nose.
Other examinations that can help doctors diagnose these conditions include:
- Repeated nerve stimulation screening, by sending a small electrical flow through the electrode, to measure the ability of the nerve to transmit the signal to the muscles. This method is repeated, to see a possible decrease in the ability to send signals, due to fatigue.
- Electromyography (EMG), to measure the electrical activity that runs between the brain and muscles.
- Blood screening for MG-related antibodies
- The Edrophonium (tensilon), performed by inserting the drug Tensilon or edrophonium chloride (or placebo through a vein vein. The patient will be asked to do muscle movements under the supervision of a physician.
- Lung function examination, to measure the breathing force that can be used to help see the likelihood of respiratory failure, causing Myasthenia crisis.
- Imaging examination using CT scans or MRI, which can get rid of tumor diagnosis.
Myasthenia Gravis Treatment
Although there is no effective way to cure Myasthenia Gravis, but the treatment given by a doctor can relieve symptoms, improve muscle function, and prevent paralysis of the respiratory muscles that are fatal.
The type of treatment also varies for each patient, depending on the age, severity, and overall condition of the patient. Some treatment measures to treat Myasthenia Gravis are:
Medicine
The types of medications used to treat the symptoms of Myasthenia Gravis include:
- Cholinesterase inhibitors, to increase muscle strength and movement. This drug is used as an initial treatment of Myasthenia Gravis. Examples of this drug are pyridostigmine and neostigmine.
- Corticosteroids, such as prednisone, inhibit the immune system from producing antibodies.
- Immunosuppressive drugs, such as azathioprine, ciclosporin, methotrexate, and tacrolimus. The drug is also used to suppress the immune system, so that antibody production can be controlled.
- Immunoglobulin (IVIG), which is a normal antibody given through an infusion to restore the immune system.
- Monoclonal antibodies, such as rituximab, are drugs given by infusion to relieve symptoms of Myasthenia Gravis that cannot be treated with other types of treatment.
Plasmapheresis
Plasmapheresis is the procedure of removing blood plasma with a special machine. The plasma will be removed and replaced with a special liquid to remove the antibodies that cause Myasthenia Gravis. These antibodies are in the blood plasma.
Surgery
If people with Myasthenia Gravis also experience an enlarged thymus gland, the doctor will perform surgery to remove the gland. This surgical procedure is called a thymectomy.
To relieve the symptoms of Myasthenia Gravis, the tthymectomy procedure is sometimes still done even though the patient does not experience an enlarged thymus gland. However, this surgical procedure is only recommended for people with myasthenia gravis, who are over 60 years old.
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