Myasthenia gravis is a neuromuscular disorder that leads to the weakness of the muscles, especially, skeletal muscles. The skeletal muscles are primarily used for movement. This disease occurs when there is a break in communication between the muscles and the nerve cells. This impaired communication between these two is responsible for the muscle weakness experienced by people affected by this disease. Organs that are most affected by this disease include the eyes and face. The process of swallowing is also affected. Some of the symptoms of this disease include double vision, problems in talking and walking, drooping eyelids and so on. One of the noticeable signs of this disease is that patients do experience an enlarged thymus gland. Myasthenia gravis is an autoimmune disease. This is a condition in which the immune system of the body doesn’t recognize the body tissues. However, in this case, the immune system fails to recognize the acetylcholine receptors, at the junction between the nerve and the muscle. This stops nerve impulses that would lead to muscle contractions. This disease is an inherited disease. Diagnosis is made by testing the blood for these specific antibodies. The edrophonium test is also another example of the kind of test done to diagnose this disease. This disease can be treated with medications. Examples of this include acetylcholinesterase inhibitors such as neostigmine, pyridostigmine and so on. In addition, immunosuppressant like prednisone or azathioprine can also be used. Other methods include the surgical removal of the thymus gland. This has improved the conditions in many cases. Stem cell therapy and exosomes are also been used in the treatment of this disease, especially in severe cases. Autologous hematopoietic stem cells are usually used for this purpose. This disease is not common in children, but prevalent in women, especially women under the age of forty. People affected with this disease can live a normal life if the disease is well managed.
What Are The Signs And Symptoms Of Myasthenia Gravis?
The most common symptom of myasthenia gravis is the weakness of muscles and tiredness. The muscles of the affected individual become progressively weak, especially during physical activities. These symptoms usually become worse towards the end of the day. Myasthenia gravis usually starts with the weakness of the eyes, which might then proceed to affect other parts of the body. Below are some of the signs and symptoms of this disease;
- Eyes: This is prevalent in a lot of people. It’s usually one of the initial symptoms of myasthenia gravis. Patients might experience symptoms such as the drooping of the eyelids, double vision, and the weakness of the extraocular muscles. The symptoms tend to worsen when the patient performs activities such as watching television, reading, driving in bright conditions.
- Eating: Myasthenia gravis leads to a condition known as dysphagia. This is a condition in which the muscles used in swallowing are affected. This causes a lot of discomfort for the patients especially when they’re trying to swallow and digest food. The patient would have some difficulty chewing and swallowing food materials, including liquid. In fact, liquid food may come out of the nose of the patient. This implies that some food would still remain in the mouth after the patient tries to swallow food or any other material. In addition, this disease impairs the function of the muscles of mastication. This would lead to problems and pain when chewing food. These symptoms are some of the earliest symptoms seen in a good percentage of Myasthenia gravis cases.
- Difficulty speaking: The auto-antibodies can also attack the muscles used in phonation. This usually alters the way affected people speak. The speech of the patient may sound nasal or soft. However, this depends on the type of muscle affected.
- Restricted facial expressions: Sometimes, the nerves controlling the facial expressions might be affected by this disease. This would eventually lead to the loss of facial expressions, such as smiling. This is usually noticed by the friends and relatives of the patient before he or she even notices.
- Muscles of the head and limbs: This disease can also cause the weakness of muscles of the head and the extremities. This disease tends to affect muscles of the upper limb, such as the arm muscles, as compared to the leg muscles. The neck muscles are also affected. In this case, patients might find it difficult holding up their head.
When Is It Important To Go See A Physician?
It’s important to go see a physician when you notice any of the following symptoms;
- Difficulty breathing
- Visual problems
- Deglutition problems
- Difficulty in walking
- Holding up the head
What Are The Causes Of Myasthenia Gravis?
- Antibodies: As earlier mentioned, myasthenia gravis is an autoimmune disease. The antibodies attack the acetylcholine receptor sites on the affected muscles. This leads to the reduction in the number of receptor sites available for acetylcholine. These antibodies can also block the function of the protein, known as the muscle-specific receptor tyrosine kinase. This protein is important in the formation of the nerve-muscular junction.
- Thymus gland: The thymus gland is a component of the immune system. It can be found behind the breastbone. The function of this organ is to produce antibodies, especially T cells. This organ might produce antibodies that would destroy the acetylcholine receptors.
- Other causes: Myasthenia gravis can also be transferred from a mother to her children. This condition is known as neonatal myasthenia gravis. Although this type of myasthenia gravis is uncommon, it does happen.
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.
Vissing, J., O’Brien, F., Wang, J. and Howard, J. (2018). Correlation between myasthenia gravis−activities of daily living (MG-ADL) and quantitative myasthenia gravis (QMG) assessments of anti−acetylcholine receptor antibody−positive refractory generalized myasthenia gravis in the phase 3 regain study. Muscle & Nerve.
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