Dr Varun Manjunath Neurologist

Myasthenia Gravis

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disorder characterized by muscle weakness and fatigue, particularly in the muscles that control eye movements, facial expressions, chewing, swallowing, and talking. In myasthenia gravis, the body's immune system mistakenly targets and attacks the neuromuscular junction, where nerve cells connect with muscles, leading to impaired communication between nerves and muscles.

Here are some key points about myasthenia gravis:

1. Muscle Weakness: Weakness and fatigue are hallmark symptoms of myasthenia gravis. Symptoms typically worsen with activity and improve with rest. Muscle weakness may fluctuate throughout the day and may be more pronounced after periods of physical exertion or later in the day.

2. Ocular Symptoms: Many people with myasthenia gravis initially experience weakness and fatigue in the muscles that control eye movements, leading to symptoms such as drooping eyelids (ptosis), double vision (diplopia), and difficulty moving the eyes.

3. Bulbar Symptoms: Weakness and fatigue in the muscles involved in chewing, swallowing, and speaking can lead to difficulty chewing solid foods, swallowing liquids or pills, and speaking clearly. Some individuals may also experience changes in their voice, such as a nasal or hoarse voice.

4. Generalized Weakness: In some cases, myasthenia gravis can progress to affect muscles throughout the body, leading to generalized weakness and fatigue. This can affect activities such as walking, lifting objects, or holding the head up.

5. Facial Weakness: Weakness in the muscles of the face can lead to drooping of the mouth or difficulty smiling or making facial expressions.

6. Respiratory Complications: Severe cases of myasthenia gravis can lead to respiratory muscle weakness, which can result in difficulty breathing and respiratory failure. This is a medical emergency and requires immediate intervention.

7. Symptoms Aggravated by Certain Factors: Symptoms of myasthenia gravis may be aggravated by factors such as stress, illness, fatigue, certain medications (such as beta-blockers or certain antibiotics), or extreme temperatures.

8. Diagnosis: Diagnosis of myasthenia gravis typically involves a thorough medical history, physical examination, and diagnostic tests such as nerve conduction studies, electromyography (EMG), and blood tests to check for antibodies associated with the condition.

9. Treatment: Treatment for myasthenia gravis aims to manage symptoms, improve muscle strength and function, and prevent complications. This may include medications such as acetylcholinesterase inhibitors (e.g., pyridostigmine), immunosuppressants (e.g., corticosteroids, azathioprine), intravenous immunoglobulin (IVIG), plasma exchange (plasmapheresis), and, in some cases, surgical removal of the thymus gland (thymectomy).

10. Lifestyle Management: Lifestyle modifications such as avoiding stress, getting adequate rest, eating a balanced diet, and conserving energy can help individuals with myasthenia gravis manage their symptoms and improve quality of life.

Myasthenia gravis is a chronic condition that requires ongoing management and monitoring by healthcare professionals, typically including neurologists and other specialists. With appropriate treatment and management strategies, many individuals with myasthenia gravis can lead fulfilling lives and effectively manage their symptoms.