Myasthenia gravis: cause, symptoms, treatment, prognosis

Myasthenia gravis is a form of muscle weakness that is based on disturbed stimulus transmission between nerves and muscles. It is an autoimmune disease that is uncommon. Myasthenia gravis occurs at all ages, in women mainly between the ages of twenty and thirty, and in men at a later age. What are causes and symptoms? How is the diagnosis made and how can this chronic condition be treated? What is the prognosis?

Article content

  • Myasthenia gravis
  • Causes of myasthenia gravis
  • Myasthenia gravis: autoimmune disease
  • Symptoms of myasthenia gravis
  • Reduction and worsening of the complaints
  • Complication myasthenia gravis
  • Symptoms of myasthenia gravis in newborns, babies
  • Diagnosis of myasthenia gravis
  • Treatment of myasthenia gravis
  • What you can do yourself if you have myasthenia gravis?
  • Prognosis myasthenia gravis
  • Someonelikeik.nl: exchanging experiences

Myasthenia gravis

Myasthenia gravis is a disease in which the transmission of stimuli between nerves and muscles is disrupted , due to an abnormality in the immune system. This leads to muscle relaxation, especially the throat muscles, facial muscles and external eye muscles. But it can also occur in other muscles, such as the respiratory muscles. The disease affects more women than men. You can get myasthenia gravis at any age, but in women mainly between the ages of twenty and thirty, men are often slightly older when the disease strikes. Tension and fatigue can make the symptoms worse. Myasthenia gravis occurs in approximately six in every hundred thousand people. The disease is not hereditary.

Causes of myasthenia gravis

  • A defect in the thymus. This is a gland that is part of the immune system. This is the cause in approximately three out of four people with myasthenia gravis.
  • In approximately one in ten people with myasthenia gravis, a benign (usually) tumor of the thymus is the cause. Such a tumor is called a thymon.
  • Myasthenia gravis can occur in combination with another autoimmune disease, such as rheumatoid arthritis.
  • Medications can also be the cause of myasthenia gravis, penicillamine is an example of this.

Myasthenia gravis: autoimmune disease

The immune system forms antibodies against recipients in muscles that receive nerve impulses. The result is that the muscles that are affected only respond moderately to nerve stimuli. The muscles around the eyes, throat and face are usually affected. Difficulties occur with speaking, vision and swallowing. Other muscles of the body can also be affected, such as those of legs, arms. It can also involve the breathing muscles, but this almost never occurs.

Symptoms of myasthenia gravis

The symptoms of myasthenia gravis often develop over weeks or months.

  • Not being able to speak clearly;
  • Eyelids that droop;
  • Someone sees double;
  • Little facial expressions;
  • Difficulty chewing;
  • Problems with swallowing;
  • Muscles of the arms and legs may be weakened.

Reduction and worsening of the complaints

The complaints usually subside with rest.
The complaints can become worse when the muscles are active, when tense and when having a period.
Major changes in temperature can also influence the complaints.

Complication myasthenia gravis

It happens rarely, but the disease can lead to breathing disorders that are life-threatening.

Symptoms of myasthenia gravis in newborns, babies

Approximately fifteen percent of children born to mothers with the disease develop symptoms of myasthenia gravis immediately after birth. The symptoms usually go away within a few weeks.

Diagnosis of myasthenia gravis

  • Based on the complaints, a GP may suspect myasthenia gravis. A referral will follow to the neurologist.
  • The neurologist may give an injection that increases the level of neurotransmitters. If this temporarily provides more strength in the muscles, it is likely that myasthenia gravis is present.
  • Furthermore, it can be checked whether there are antibodies in the blood that target the muscle receptors of nerve impulses.
  • The electrical activity can be examined to determine whether there is sufficient response to nerve stimuli.
  • A thymoma can be detected by a CT scan or MRI.

Treatment of myasthenia gravis

  • Medication to increase the level of neurotransmitters. If you have a mild form, you can lead a normal life again with these medications.
  • If the symptoms persist, corticosteroids or other immunosuppressive agents can be prescribed to reduce the production of antibodies. If you start treatment with corticosteroids, this will be done in the hospital because the complaints may get worse in the beginning.
  • Sometimes regular plasmapheresis is necessary, this is in severe cases. Blood plasma is taken from the body, the antibodies against the muscle receptors are removed and what remains is reintroduced into the body.
  • In people who are not yet forty-five and who have severe complaints, the thymus can be removed. This can lead to improvement.
  • If there is a tumor in the thymus, the gland will be removed. A tumor can become malignant.
  • If you have breathing problems, breathing support may be necessary.

What you can do yourself if you have myasthenia gravis?

Avoid: major changes in temperature, infections, tension and over-fatigue because these aggravate muscle weakness.

Prognosis myasthenia gravis

Cure is not possible, people must be treated for the rest of their lives. In people without thymoma, life expectancy is normal. In fifteen to twenty percent of cases you can say that the disease ‘extinguishes’ and people therefore eventually become completely free of complaints. A lot has changed, in the past people died from weakness of the respiratory muscles. Nowadays, due to good treatment, this is no longer the case.

Someonelikeik.nl: exchanging experiences

People with a muscle disease can exchange experiences on the website wonenlikeik.nl. It is a site for and by people with a chronic condition.