The body is supported by nerves and skeletal muscles to help you move freely. So, the problem or interference with the nerves and muscles will certainly adversely affect your ability to move. Myasthenia gravis is one of the neuromuscular disorders that causes muscle weakness that most often attacks people around middle age. Usually, this disease starts to appear in women before the age of 40 years and men after 60 years. For more details, see the following review.
Myasthenia gravis is an autoimmune disease
Myasthenia gravis is an autoimmune disease. Autoimmune disease is a disease that occurs due to the immune system (immune system) even attacking cells and healthy tissue in your own body, rather than foreign substances that cause disease.
The immune system attacks your own body by creating the same antibodies that should be used to attack bacteria, viruses, and other foreign objects in the body.
Now in the case of myasthenia gravis, antibodies block or destroy the acetylcholine receptor on the skeletal muscle joint which causes a disruption of communication between the nerves and muscles. As a result, your muscles receive fewer nerve signals resulting in weakness.
What is the cause of myasthenia gravis?
Until now scientists have not found the exact cause of myasthenia gravis. There is a theory that infection can be a risk factor. Proteins from certain viruses or bacteria allegedly can make acetylcholine in the body unable to work effectively.
In addition, genetic factors and changes in the thymus gland are thought to be other triggers. Most patients with myasthenia gravis have benign tumors and enlargement of the thymus gland.
What are the signs and symptoms of myasthenia gravis?
The main symptom of myasthenia gravis is the weakening of the skeletal muscles. Skeletal muscles are the muscles that we can control and move consciously to do something. For example, facial muscles, eyes, throat, arms, and legs.
Some symptoms that appear when the muscles weaken, such as:
- Difficulty speaking.
- Difficulty swallowing, so it often chokes.
- Difficulty in chewing, because the muscles responsible for chewing start to weaken.
- Facial muscles weaken so that the face looks paralyzed.
- Difficulty breathing because of the weakness of the chest wall muscles.
- The voice changes hoarse.
- Eyelids drooping.
- Double vision or diplopia.
Myasthenia gravis is also characterized by rapid fatigue after moving muscles.
Signs and symptoms that arise in each person will usually be different and not always the same. If it is not immediately treated, after a long time the symptoms that appear can develop to get worse. Usually, the symptoms of myasthenia gravis will worsen as more activity you do.
If you are concerned about the appearance of abnormal symptoms, immediately consult with your doctor.
What is the right way to diagnose myasthenia gravis?
First, the doctor will ask for your medical history and then proceed with a complete physical examination. Starting from checking the body's reflexes, finding the location of muscle weakness, ensuring the accuracy of eye movements, to checking the body's motor functions.
If needed, some further tests will help the doctor to diagnose your health condition, for example:
- Repeated nerve stimulation test.
- Blood test to check for antibodies.
- tensilon test.
- CT Scan.
So, what is the right treatment for this condition?
Consumption of drugs
Corticosteroid drugs such as prednisolone, and immunosuppressant drugs such as azathioprine, can be used to help suppress the body's excessive immune response. In addition, the administration of cholinesterase inhibitors, such as pyridostigmine (Mestinon), is believed to facilitate communication between nerve cells and muscles.
Thymus gland removal
If myasthenia gravis is caused by the appearance of a tumor in the thymus gland, surgery is needed to remove the thymus gland before the tumor develops into a cancer cell. This procedure is called thymectomy.
After the thymus gland is removed, usually muscle weakness that may have been quite severe will recover slowly.
Plasmapheresis and immunoglobulin therapy
For patients with severe symptoms, the plasmapheresis procedure and immunoglobulin therapy can be an option.
Plasmapheresis, or what is known as plasma exchange, aims to get rid of harmful antibodies in the blood. This is a short-term treatment, so it is usually used before the surgery or when the body's muscles are being hit by weakness due to myasthenia gravis.
As for immunoglobulin therapy, donors from blood with normal antibodies are needed. The goal is to change the work of antibodies in the body. Actually this treatment is quite effective, but only applies to short-term.
Apart from treatment from a doctor, changing your lifestyle can help relieve the symptoms of myasthenia gravis. For example by maximizing rest periods to help minimize muscle weakness; avoid stress because it can actually worsen symptoms; don't forget to always check regularly to track the progress of the disease while knowing your health condition.
If you feel disturbed by double vision, immediately talk to your doctor to get the best solution. Treatment as described previously does not immediately cure myasthenia gravis. But at the very least, you will feel changes in symptoms that are getting better.
Are there any complications that can arise from myasthenia gravis?
One of the most dangerous complications of myasthenia gravis is the emergence of myasthenic crisis.
Myasthenic crisis occurs when the respiratory muscles weaken, so you will have difficulty breathing normally. That is why sufferers of myasthenic crisis complications need emergency help with a breathing apparatus.
Not only that, myasthenia gravis sufferers are also prone to various other autoimmune diseases - such as lupus, rheumatism and thyroid problems.
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