Myasthenia is a chronic autoimmune neuromuscular disease that affects the skeletal muscles. This disease causes various degrees of weakness of the skeletal muscle. Some of the organs commonly affected by this disease include the face, eyes, and the muscles involved in swallowing. This impairs the functions of the organs mentioned above. Patients usually present with signs and symptoms such as double vision, difficulty walking, impaired speech, difficulty in swallowing, drooping eyelids, and so on. This disease occurs when the immune system attacks the healthy cells of the body. In this case, the immune system attacks the nicotinic acetylcholine receptors. These receptors can be found at the junction of the skeletal muscles and the nerves. This impairs the movement of impulses and signals from the nerves to the muscles. Genetics is an important factor in the development of the disease. This is because it can be passed down from parents to children. Physicians diagnose this disease by carrying out blood tests. Some specific antibodies are tested for. In addition, edrophonium test could also be carried out. This disease is treated with medications. Examples of such medication are acetylcholinesterase inhibitors, such as neostigmine, and pyridostigmine. In addition, immunosuppressant is also used, such as azathioprine and prednisone. In severe cases, the thymus of the patient can be removed. Stem cell therapy has been successfully used in the treatment of this disease. This was done by doing autologous hematopoietic stem cell transplantation. This basically means that stem cells are extracted from the bone marrow of the patient, and then transplanted into the patients. Stem cells are unique cells that are capable of differentiating into other types of cells. They can self-regenerate, and also have the ability to replace and repair any damaged or injured cell receptors, in this case.
What Causes Myasthenia Gravis?
Myasthenia gravis occurs when there is an impairment in the transmission of impulses from the nerves to the skeletal muscles. This occurs at the neuromuscular junction-where the muscles meet with the nerves, on a cellular level. Normally, the nerves communicate with the muscles by releasing neurotransmitters, that fits into the receptor sites on the muscles. However, in myasthenia gravis, the body immune system attacks the receptor sites of these neurotransmitters. This reduces the number of receptor sites that would receive the transmitters, released by the nerves. This is what leads to the signs and symptoms presented by the affected persons.
What Are the Early Signs and Symptoms of Myasthenia Gravis?
The signs and symptoms of myasthenia gravis tend to get worse, as the muscles affected are repeatedly used. However, the symptoms improve when the patient rests the muscle affected. Although myasthenia gravis can affect any skeletal muscle of the body, it commonly affects the muscles of the eyes, face, throat, neck and limb muscles. Below are some of the symptoms of the disease:
- Eye muscles: The impairment of the eye muscles, is one of the earliest symptoms presented by persons affected with myasthenia gravis. Patients do present with the drooping of the eyelids. Other symptoms include double vision. This can be vertical or horizontal. Although, as earlier mentioned, the symptoms improve when the eyes are closed and rested.
- Face and throat muscles: This disease affects the muscles of the face and throat, in about 15% of patients. Some of the symptoms presented include the following;
- Impaired speech: Persons affected with this disease find it difficult to speak. This occurs because the muscles of the throat are affected by the disease. Patients might sound nasal and soft.
- Difficulty in swallowing: Patients affected with this disease find it difficult to swallow There have been cases of patients choking on food. Apart from finding it difficult to swallow food, patients do also choke on liquids.
- Difficulty chewing food: Since myasthenia gravis affects the muscles of mastication. Patients do find it difficult chewing their food.
- Impaired facial muscles: Myasthenia gravis also affects the muscles of facial expression. This affects the way the patients smile, and so on.
- Muscles of the neck and extremities: Myasthenia gravis can cause the weakness of the muscles of the neck and the extremities. The muscles of the extremities include the arms and legs. This usually occurs in combination with the weakness of the eyes, throat and facial muscles. This condition might make it difficult for patients to walk, and also makes their neck weak, making it difficult for them to have a normal
Who Gets Affected by Myasthenia Gravis?
Myasthenia gravis can affect anyone, regardless of gender, race, and age. However, studies have shown that this disease mostly affects women that are under the age of 40, and men that are over the age of 60. This disease rarely occurs in infants.
How Is Myasthenia Gravis Diagnosed?
Physicians diagnose this disease by first evaluating the signs and symptoms presented by the patient. Further tests are then carried out to exclude other diseases, and to confirm the diagnosis. Some of the tests include the following:
- Neurological examination: After carrying out a physical examination on the patient, and taking the medical and family history of the patient. The physician will check for the tone of the muscles, the sense of touch, and also check for any dysfunction of the eyes.
- Blood test: Persons affected with myasthenia gravis do have an elevated amount of acetylcholine receptor antibodies. However, it’s important to know that some myasthenia gravis patients might test negative for the presence of the antibodies.
Stem cell therapy and Myasthenia gravis
Stem cell therapy has been successfully used in the treatment of this disease. This was done by doing autologous hematopoietic stem cell transplantation. This basically means that stem cells are extracted from the bone marrow of the patient, and then transplanted into the patients. Stem cells are unique cells that are capable of differentiating into other types of cells. They can self-regenerate, and also have the ability to replace and repair any damaged or injured cell receptors, in this case.
References
Morren, J. and Li, Y. (2018). Myasthenia gravis with muscle-specific tyrosine kinase antibodies: A narrative review. Muscle & Nerve.
Papapetropoulos, T. (2003). Development of Generalized Myasthenia Gravis in Patients With Ocular Myasthenia Gravis. Archives of Neurology, 60(10), p.1491.
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