Learn About Myasthenia Gravis

What is the definition of Myasthenia Gravis?

Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.

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What are the alternative names for Myasthenia Gravis?

Neuromuscular disorder - myasthenia gravis

What are the causes of Myasthenia Gravis?

Myasthenia gravis is a type of autoimmune disorder. An autoimmune disorder occurs when the immune system mistakenly attacks healthy tissue. Antibodies are proteins made by the body's immune system when it detects harmful substances. Antibodies may be produced when the immune system mistakenly considers healthy tissue to be a harmful substance, such as in the case of myasthenia gravis. In people with myasthenia gravis, the body produces antibodies that block the muscle cells from receiving messages (neurotransmitters) from the nerve cells.

In some cases, myasthenia gravis is linked to tumors of the thymus (an organ of the immune system).

Myasthenia gravis can affect people at any age. It is most common in young women and older men.

What are the symptoms of Myasthenia Gravis?

Myasthenia gravis causes weakness of the voluntary muscles. These are muscles that you can control. Autonomic muscles of the heart and digestive tract are usually not affected. The muscle weakness of myasthenia gravis worsens with activity and improves with rest.

This muscle weakness can lead to a variety of symptoms, including:

  • Breathing difficulty because of weakness of the chest wall muscles
  • Chewing or swallowing difficulty, causing frequent gagging, choking, or drooling
  • Difficulty climbing stairs, lifting objects, or rising from a seated position
  • Difficulty talking
  • Drooping head and eyelids
  • Facial paralysis or weakness of the facial muscles
  • Fatigue
  • Hoarseness or changing voice
  • Double vision
  • Difficulty maintaining steady gaze
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What are the current treatments for Myasthenia Gravis?

There is no known cure for myasthenia gravis. Treatment may allow you to have periods without any symptoms (remission).

Lifestyle changes can often help you continue your daily activities. The following may be recommended:

  • Resting throughout the day
  • Using an eye patch if double vision is bothersome
  • Avoiding stress and heat exposure, which can make symptoms worse

Medicines that may be prescribed include:

  • Neostigmine or pyridostigmine to improve communication between the nerves and muscles
  • Prednisone and other drugs (such as azathioprine, cyclosporine, or mycophenolate mofetil) to suppress the immune system response if you have severe symptoms and other medicines have not worked well
  • Other immunological therapies target specific immune cells or inflammatory response

Crisis situations are attacks of weakness of the breathing muscles. These attacks can occur without warning when either too much or too little medicine is taken. These attacks usually last no longer than a few weeks. You may need to be admitted to the hospital, where you may need breathing assistance with a ventilator.

A procedure called plasmapheresis may also be used to help end the crisis. This procedure involves removing the clear part of the blood (plasma), which contains the antibodies. This is replaced with donated plasma that is free of antibodies, or with other fluids. Plasmapheresis may also help reduce symptoms for 4 to 6 weeks and is often used before surgery.

A medicine called intravenous immunoglobulin (IVIg) may also be used

Surgery to remove the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present.

If you have eye problems, your doctor may suggest lens prisms to improve vision. Surgery may also be recommended to treat your eye muscles.

Physical therapy can help maintain your muscle strength. This is especially important for the muscles that support breathing.

Some medicines can worsen symptoms and should be avoided. Before taking any medicine, ask your doctor whether it is OK for you to take it.

Who are the top Myasthenia Gravis Local Doctors?
Elite
Highly rated in
4
conditions
Neurology

Duke Health

Duke Neurological Disorders Clinic - 1L

40 Duke Medicine Cir 
Durham, NC 27710

Janice Massey is a Neurologist in Durham, North Carolina. Dr. Massey has been practicing medicine for over 44 years and is rated as an Elite doctor by MediFind in the treatment of Myasthenia Gravis. She is also highly rated in 4 other conditions, according to our data. Her top areas of expertise are Myasthenia Gravis, Drug Induced Dyskinesia, Lambert-Eaton Syndrome, and Meige Syndrome. She is licensed to treat patients in North Carolina. Dr. Massey is currently accepting new patients.

Elite
Highly rated in
18
conditions

University Of Toronto

Department Of Medicine 
Toronto, ON, CA 

Vera Bril is in Toronto, Canada. Bril is rated as an Elite expert by MediFind in the treatment of Myasthenia Gravis. She is also highly rated in 18 other conditions, according to our data. Her top areas of expertise are Myasthenia Gravis, Diabetic Neuropathy, Sensorimotor Polyneuropathy, and Autonomic Neuropathy.

 
 
 
 
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Learn more
Elite
Highly rated in
66
conditions
Neurology

Duke Health

Private Diagnostic Clinic

40 Duke Medicine Cir 
Durham, NC 27710

Vern Juel is a Neurologist in Durham, North Carolina. Dr. Juel has been practicing medicine for over 33 years and is rated as an Elite doctor by MediFind in the treatment of Myasthenia Gravis. He is also highly rated in 66 other conditions, according to our data. His top areas of expertise are Myasthenia Gravis, Lambert-Eaton Syndrome, Charcot-Marie-Tooth Disease, and Sensorimotor Polyneuropathy. He is licensed to treat patients in North Carolina. Dr. Juel is currently accepting new patients.

What are the support groups for Myasthenia Gravis?

You can ease the stress of illness by joining a myasthenia gravis support group. Sharing with others who have common experiences and problems can help you not feel alone.

What is the outlook (prognosis) for Myasthenia Gravis?

There is no cure, but long-term remission is possible. You may have to restrict some daily activities. People who have only eye symptoms (ocular myasthenia gravis), may develop generalized myasthenia over time.

A woman with myasthenia gravis can get pregnant, but careful prenatal care is important. The baby may be weak and require medicines for a few weeks after birth, but usually will not develop the disorder.

What are the possible complications of Myasthenia Gravis?

The condition may cause life-threatening breathing problems. This is called a myasthenic crisis.

People with myasthenia gravis are at higher risk for other autoimmune disorders, such as thyrotoxicosis, rheumatoid arthritis, and systemic lupus erythematosus (lupus).

When should I contact a medical professional for Myasthenia Gravis?

Call your health care provider if you develop symptoms of myasthenia gravis.

Go to the emergency room or call 911 or the local emergency number if you have breathing difficulty or swallowing problems.

Superficial anterior muscles
Ptosis - drooping of the eyelid
Central nervous system and peripheral nervous system
What are the latest Myasthenia Gravis Clinical Trials?
Morphometric Study of the Muscles of the Skin in MRI 3 Tesla in Patients With Facial Paralysis.
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A Long-term, Single-Arm, Open-label, Multicenter, Follow-on Trial of ARGX-113-2006 to Evaluate Safety of Efgartigimod Administered Intravenously in Children With Generalized Myasthenia Gravis
What are the Latest Advances for Myasthenia Gravis?
Giant cell myositis associated with metastatic thymoma and granulomatous hypercalcaemia.
Intrapericardial Thymoma Presented as Pericardial Tamponade with Post-Operative Myasthenia Gravis.
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Venous sinus thrombosis after the first dose of Pfizer BioNTech vaccine.
Who are the sources who wrote this article ?

Published Date: May 04, 2021
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Chang CWJ. Myasthenia gravis and Guillain-Barré syndrome. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 61.

Guptill JT, Sanders DB. Disorders of neuromuscular transmission. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 108.

Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016;87(4):419-425. PMID: 27358333 pubmed.ncbi.nlm.nih.gov/27358333/.