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Myasthenia Gravis

Myasthenia Gravis

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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
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05/31/2013

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Myasthenia Gravis
Definition

Myasthenia gravis (mi-uhs-THE-ne-uh GRA-vis) is characterized by weakness and
rapid fatigue of any of the muscles under your voluntary control. The cause of
myasthenia gravis is a breakdown in the normal communication between nerves and
muscles.

There is no cure for myasthenia gravis, but treatment can help relieve signs and symptoms \u2014 such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing.

While myasthenia gravis can affect people of any age, it's more common in women younger than 40 and in men older than 60. The disorder occurs in one or two people per 10,000.

Symptoms

Muscle weakness caused by myasthenia gravis worsens as the affected muscle is used repeatedly. Since symptoms typically improve with rest, your muscle weakness may come and go. While myasthenia gravis can affect any of the muscles that you control voluntarily, certain muscle groups are more commonly affected than others.

Eye muscles
In more than half the people who develop myasthenia gravis, their first signs and
symptoms involve eye problems, such as:
\ue000
Drooping of one or both eyelids (ptosis)
\ue000
Double vision (diplopia), which may be horizontal or vertical
\ue000
Blurred vision, which may come and go
Face and throat muscles
In about 15 percent of people with myasthenia gravis, the first symptoms involve face
and throat muscles, which can cause difficulties with:
\ue000
Speaking. Your speech may be very soft or sound nasal, depending upon
which muscles have been affected.
\ue000
Swallowing. You may choke very easily, which makes it difficult to eat, drink
or take pills. In some cases, liquids you're trying to swallow may come out
your nose.
\ue000
Chewing. The muscles used for chewing may wear out halfway through a
meal, particularly if you've been eating something hard to chew, such as steak.
\ue000
Facial expressions. Family members may note that you've "lost your smile" if
the muscles that control your facial expressions are affected.
Arm and leg muscles

Myasthenia gravis can cause weakness in your arms and legs, but this usually happens
in conjunction with muscle weakness in other parts of your body \u2014 such as your
eyes, face or throat. The disorder usually affects arms more often than legs. However,
if it affects your legs, you may waddle when you walk.

When to see a doctor
Talk to your doctor if you have trouble:
\ue000
Breathing
\ue000
Seeing
\ue000
Swallowing
\ue000
Chewing
\ue000
Walking
Causes
Receptors
Thymus gland

Your nerves communicate with your muscles by releasing chemicals, called
neurotransmitters, which fit precisely into receptor sites on the muscle cells. In
myasthenia gravis, your immune system produces antibodies that block or destroy
many of your muscles' receptor sites for a neurotransmitter called acetylcholine. With
fewer receptor sites available, your muscles receive fewer nerve signals, resulting in
weakness.

It's believed that the thymus gland, a part of your immune system located in the upper
chest beneath the breastbone, may trigger or maintain the production of these
antibodies. Large in infancy, the thymus is small in healthy adults. But, in some adults
with myasthenia gravis, the thymus is abnormally large. Some people also have
tumors of the thymus. Usually, thymus gland tumors are noncancerous.

Some factors can make myasthenia gravis worse, including:
\ue000
Fatigue
\ue000
Illness
\ue000
Stress
\ue000
Extreme heat
\ue000
Some medications \u2014 such as beta blockers, calcium channel blockers, quinine and some
antibiotics
Complications
Complications of myasthenia gravis are treatable, but some can be life-threatening.
Myasthenic crisis

Myasthenic crisis is a life-threatening condition, which occurs when the muscles that
control breathing become too weak to do their jobs. Emergency treatment is needed to
provide mechanical assistance with breathing. Medications and blood-filtering
therapies help people recover from myasthenic crisis, so they can again breathe on
their own.

Thymus tumors

About 15 percent of the people who have myasthenia gravis have a tumor in their
thymus, a gland under the breastbone that is involved with the immune system. Most
of these tumors are noncancerous.

Other disorders
People who have myasthenia gravis are also more likely to have the following
problems:
\ue000
Underactive or overactive thyroid. The thyroid gland, located in the neck,

secretes hormones that regulate your metabolism. If your thyroid is
underactive, your body uses energy more slowly. An overactive thyroid makes
your body use energy too quickly.

\ue000
Lupus. Lupus is a disease in which your immune system attacks certain parts
of your body. Common symptoms include painful or swollen joints, hair loss,
extreme fatigue and a red rash on the face.

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