Myasthenia Gravis: Symptoms, Causes and Factors

Myasthenia Gravis (MG) affects 150 to 200 million people with a neuromuscular, and autoimmune disease that attacks the body itself. It is a rare, chronic condition. It results in weakening and rapid fatigue of the nerves and skeletal muscles responsible for the control of your arms, legs, and breathing. The communication system between the nerves and muscles is compromised.

Over half the persons with this In MG over 50 percent develop the first signs in the muscles of the eyes and in 15 percent in the muscles of the face and throat.

Chemicals called neurotransmitters (specifically acetylcholine) allow the nerves to communicate with the muscles. They fit exactly into the receptor sites on the muscle’s sites at the nerve-muscle intersection. In myasthenia gravis, the immune system creates antibodies that impede or destroy many of these receptor sites for designed to receive the neurotransmitter. Because fewer sites are available, your muscles receive fewer nerve signals, resulting in decreased strength.

Symptoms

• Drooping of a single or both eyelids otherwise known as ptosis.
• Double vision, otherwise called diplopia, can be of a horizontal or vertical nature and which improves when one eye is shut
• Problems making facial expressions which may be a vacant stare or a smile may look like an irritated expression).
• Speech is impaired and may be slurred, soft or nasally.
• Problems swallowing so that chewing a tough food item like a pork chop or drinking a beverage of a water like consistency like apple juice may become problematic, a fluid may accidentally come out of the nose.
• Decreased strength in neck, legs, and arms, with problems holding head erect.
• Shortness of breath occasionally becomes very problematic.

The symptoms tend to get more problematic when you're fatigued at the end of the day. They generally get better in the morning after some sleep. Symptoms get worse over time. They reach their worst s couple years after the start of the disease.

Causes

Chemicals called neurotransmitters (specifically acetylcholine) allow the nerves to communicate with the muscles. They travel across the space/junction and fit exactly into the receptor sites on the muscle’s sites at the nerve-muscle space. In myasthenia gravis, the immune system creates antibodies that impede or destroy many of these receptor sites for designed to receive the neurotransmitter. Because fewer sites are available, your muscles receive fewer nerve signals, resulting in decreased strength. In some people there can be as much as an 80% reduction in muscle receptor sites.

Antibodies can also impede the function of a protein called muscle-specific tyrosine kinase, occasionally referred to as MuSK. This protein is required to form the nerve-muscle space. Antibodies against this protein result in MG. MG can also develop due to an antibody against another protein, named lipo-related protein 4 or LRP4.

Other antibodies will likely grow over time according to research. A couple of individuals have myasthenia gravis but do not have these proteins. This type of MG is named antibody-negative myasthenia gravis. Researchers believe these forms of MG continue to have an autoimmune premise, but the antibodies have yet to be discovered.

Factors behind MG

• It typically starts in men over 60 and women under 40 but can affect anyone of any age.
• There is a hereditary form of myasthenia gravis called congenital MG that some children can be born with.
• Infrequently mothers with MG have children born with neonatal MG. If treated immediately the child usually recovers within two months after birth.

Factors that can worsen myasthenia gravis

• Illness
• Stress
• Infection
• Surgery
• Pregnancy
• Menstrual periods
• Some medications — such as some anesthetics, certain antibiotics, quinidine gluconate, phenytoin, beta blockers, quinidine sulfate, quinine (Qualaquin)

Types of myasthenia gravis

• Congenital MG is a type of myasthenia gravis that occurs in two to twelve per million individuals. It is typically inherited from both parents. The congenital form is determined by the exact congenital defect. The specific genetic defect determines the congenital type. Each type may have a different grouping of symptoms and treatment alternatives.
• There is another category of people specifically affected with ocular symptoms of drooping eyelids and double vision. This occurs in ten to forty percent. About ten to forty percent of those with MG. It is limited to the eyes and does not spread to any other muscles in the body.
• Generalized myasthenia gravis affects 50 to 80 percent of persons and results in widespread weakness that can affect the eyes, face, throat and arms, and legs. It can affect the breathing muscles in 10 percent of those with MG. When breathing becomes very difficult it can cause a life-threatening episode called an MG crisis. MG is more prevalent in women, particularly those younger than 40 years of age.
• Fifty to eighty percent of people with MG experience the generalized form of myasthenia gravis which causes widespread weakness. Breathing is affected in ten percent. An MG crisis, a life-threatening occurrence can happen as a result.
• Another type of MG is transient neonatal myasthenia gravis which is so rare it affects only 10 to 20 percent of babies born to women with MG. The mother develops self-reactive antibodies and transfers them to the unborn fetus. Newborn babies demonstrate weakness overall as well as have swallowed, sucking, crying, and breathing issues. Although these symptoms are significant they only last a couple of days to a couple of weeks.
• The final type of myasthenia gravis is juvenile MG which starts before puberty. Again, this type is limited to eye disturbances, but more serious forms can affect other muscles of the body. Symptoms can vary from limited coordination to swallowing difficulties. These young patients have a greater potential to achieve occasional remission than adults, but relapses can reoccur.

Myasthenia Gravis is a complex disease in which the body attacks itself. It has some typical symptoms including weakness in various parts of the body more so in the eye muscles. Types of MG and treatment will be discussed in the following column.

Myasthenia Gravis is difficult to manage and necessitates a medical evaluation. However, a number of variables affect the illness' long-term prognosis. Speak with your doctor to lessen the severity of your health issue because a timely diagnosis and effective therapy can slow the advancement of the disease.