Myasthenia gravis is an autoimmune neuromuscular disease in which the immune system attacks its own cells, causing weakness in certain muscles. The eyelids and muscles around the eyes, jaw muscles, arm muscles, leg muscles and muscles that help breathing can be adversely affected. Symptoms may vary depending on the muscles affected by the disease. The treatment of this rare condition aims to control symptoms and improve the patient's quality of life.
In this disease, which is the most common disorder of nerve-muscle transmission, many different complaints such as droopy eyelids, blurred vision, double vision, difficulty chewing or swallowing, difficulty speaking and difficulty breathing can be seen. Health problems arising from neurological diseases can have a serious negative impact on a person's daily life. In such cases, you should go to the nearest health institution immediately and the necessary controls should be made.
What are the Causes of Myasthenia Gravis?
According to research, it has been stated that a previous viral infection may be responsible for the immune system seeing its own cells as a threat and attacking them. In addition, tumor tissue is found in the thymus gland in about 10 to 15 percent of cases. This condition, known as thymoma, has the risk of developing into cancer.
Since the thymus gland is the main organ from which the cells of the immune system arise, it is thought that this may be due to the immune mechanisms underlying myasthenia gravis, as the removal of the thymus gland has been found to reduce symptoms in individuals with thymoma during treatment.
According to evaluations and research, it has been observed that cases are more common in individuals over the age of 40 and women. This disease, which can be seen in male individuals, usually begins to show symptoms after the age of 60.
What are the Symptoms of Myasthenia Gravis?
The main symptom seen among the symptoms of myasthenia gravis is known as muscle weakness and often true muscle fatigue. Muscle fatigue occurs due to a decrease in the contractile strength of the muscles and fatigue is observed in certain muscles. The severity of the resulting muscle weakness and fatigue varies. Symptoms can be mild or severe, and there is no period without symptoms. The complaints and symptoms that occur in most cases can be listed as follows:
- Due to the involvement of the eyelids and muscles around the eyes, complaints such as droopy eyelids, decreased vision, blurred vision or double vision may occur.
- Due to the involvement of the muscles in the jaw and neck area, complaints such as eating disorders, difficulty in chewing, difficulty in swallowing or swallowing, and difficulty in speaking may occur.
- There may be complaints such as a feeling of heaviness in the head or the head falling forward.
- When the muscles that help breathing are affected, symptoms such as strong breathing and shortness of breath may occur. Depending on the severity of this condition, there may be a risk to life.
- In case of weakness in the arm or leg muscles, difficulty in arm and leg movements may occur, as well as finger opening and foot lifting.
How is Myasthenia Gravis Diagnosed?
Myasthenia gravis is diagnosed as a result of clinical evaluations made by specialist doctors. Having symptoms of the disease, learning the person's disease history in detail and a detailed physical examination are important for diagnosis.
During the physical examination, the person's muscle reflexes and muscle strength are tested. The presence of different neurological findings is also checked. After the evaluations, blood tests and different imaging methods can be used upon the request of the specialist.
Electromyography (EMG) can be used to measure the responses of the patient's muscle groups to nerve impulses. In this method, an artificial contraction signal is sent through the device to a specific muscle group and the muscle's responses are measured.
In addition, computed tomography or magnetic resonance imaging (MRI) is used to examine the thymoma status of the patient. In addition, a tensilon test can be performed to see whether the weakness in the muscles will improve through the drug called edrophonium.
What are Myasthenia Gravis Treatment Methods?
Although there is no definitive treatment for myasthenia gravis, in the treatment planning of this disease, studies are generally carried out to eliminate symptoms and control the disease. With daily treatment applications, it is aimed to improve the quality of life of patients and prevent the progression of the disease.
Medication is one of the most preferred treatment methods. Immunosuppressive drugs, corticosteroids and cholinesterase inhibitors that benefit muscle weakness are applied. In this context, the immune response that causes destruction of receptors is blocked and nerve transmission to the muscles is controlled.
In cases where medication does not help, a method called 'plasmapheresis' is applied. The patient's blood is purified from disease-causing antibodies in a separate device and returned to the patient. As a result of the removal of the antibodies causing the disease from the body, symptoms are alleviated. This application is preferred especially in cases where symptoms are severe and before thymoma operation.
If a thymoma is observed in the patient, this tumor must be removed by surgery. Thanks to this method, the patient is prevented from developing thymus cancer and symptoms can be controlled.
Intravenous immunoglobulin (IVIG) is used to eliminate harmful antibodies in the patient's blood. It is generally preferred as an alternative to drug treatment.
In addition to the above-mentioned methods, it is also important for patients to make some changes in their lifestyle. In order to reduce muscle weakness, the patient should rest frequently and may be advised to stay away from factors such as stress and hot places.
Medications can increase the symptoms and signs of the disease and make the condition more severe. In order to prevent this situation, it is important for the person to go for check-ups at intervals determined by the specialist doctor and not to interrupt them.