Myasthenia Gravis

What is Myasthenia Gravis?

Myasthenia Gravis is a neuromuscular disease that affects the transmission of nerve impulses to muscles, caused by an autoimmune disorder in which antibodies block or destroy nicotinic acetylcholine receptors at the neuromuscular junction. The disease causes chronic, fluctuating, skeletal muscle weakness that worsens over time and can also cause ocular muscle weakness leading to double vision and drooping eyelids.

Symptoms

  • The most common symptom of Myasthenia Gravis is muscle weakness . The weakness may occur frequently or for short periods, usually lasts 1 to 2 weeks, and can affect any part of your body. You may find it hard to raise your head, swallow food or speak clearly. You may notice that the weakness appears after you’ve been physically or emotionally stressed.

    Other symptoms may include:

    • Extreme fatigue after physical exertions, exercise, excitement, or stress
    • Drooping eyelids and/or blurred or double vision
    • Weakness in the arms, legs, stomach muscles or face
    • Problems swallowing or breathing
    • Cognitive issues with memory or concentration
     

Diagnosis

Our neurology team will review your symptoms, your medical history and conduct a physical examination. Neurological testing may be used to evaluate the health of your reflexes, muscle strength, muscle tone, sensory of touch and/or sight, balance, coordination, or gait. Neurological Testing may include:

  • Ice Pack Test – If you have a droopy eyelid, your doctor might place a bag filled with ice on your eyelid and remove the ice to determine signs of improvement after a few, short minutes.
  • Blood Test- A blood test will indicate the presence of abnormal antibodies that disrupt the receptor sites where nerve impulses signal your muscles to move.
  • Repetitive Nerve Stimulation – The neurologist will attach electrodes to your skin over the muscles to be tested. Small electrical pulses are administered through electrodes and measure the nerve’s ability to send a signal to your muscle. The nerve may be tested repeatedly to see if its ability to send signals worsens over time, and with repeated exposure.
  • Single-fiber electromyography (EMG) – A test used to measure the electrical activity traveling between your brain and your muscle. This test is preformed by inserting a small wire electrode through your skin and into a muscle fiber.
  • Imaging – Our neurologist might order a CT scan or an MRI to check if there’s a tumor or other abnormality in your thymus.
  • Pulmonary Function Tests – This test evaluates whether your condition is affecting your breathing.

Treatment

The main goal of treating Myasthenia Gravis is to stop or prevent worsening muscle weakness and/or breathing problems.

Treatments may include:

  • Medication: Prescriptions can be used to suppress the immune system and help improve muscle strength.
  • Neurosurgery: The thymus gland in Myasthenia Gravis patients produces antibodies that cause Myasthenia Gravis. Neurosurgery may be recommended to remove the thymus and produce long-term remission for Myasthenia Gravis.

 


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