MYASTHENIA GRAVIS

General Information

DEFINITION--Disorder of muscles, especially of the face and head, with increasing fatigue and weakness as muscles are used.

BODY PARTS INVOLVED--The muscles around the eyes, mouth and throat, and the extremities.

SEX OR AGE MOST AFFECTED--Both sexes; all ages, but more common in adolescents and young adults and in females.

SIGNS & SYMPTOMS

• Drooping eyelids.
• Double vision (diplopia).
• Loss of normal facial expression.
• Swallowing difficulty.
• Weakness of the arms and legs.
• Difficulty speaking clearly.
• Breathing difficulty. Most flare-ups appear after a brief period of normal muscle function and worsen as the muscle is used.

CAUSES

• Autoimmune disorder (probably).
• Tumor of the thymus (newborns only).

RISK INCREASES WITH

• Medical history of other autoimmune diseases.
• Some cancers, especially thymus and lung cancer.
• Newborns and infants of mothers with myasthenia gravis. They show symptoms in 2 to 3 weeks.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests include laboratory studies of antibodies in the blood, electrical muscle tests, x-rays of the chest and a therapeutic trial of anticholinesterase drugs.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment is directed towards controlling symptoms.
• Surgical removal of the thymus gland (thymectomy) (sometimes).
• Acute flare-ups may require emergency care for respiratory distress.

POSSIBLE COMPLICATIONS

• Choking from swallowing difficulty.
• Respiratory paralysis.

PROBABLE OUTCOME--This condition is currently considered incurable. However, symptoms can be relieved or controlled. Worsening may be followed by improvement. Life expectancy is reduced but patients usually live many years with the disease. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES--

• To feel more confident about how to treat yourself, ask your doctor about the following: About your medications and the importance of compliance. How to adjust to progressive fatigue and weakness. How to prevent and manage complications. How to recognize signs of myasthenic crisis.
• Wear a Medic-Alert (See Glossary) bracelet or neck tag that indicates your medical problem.
• See Resources for Additional Information.

MEDICATION--

• Anticholinesterase drugs to restore normal muscle function. Excessive doses may cause weakness.
• Cortisone drugs at times when symptoms worsen.

ACTIVITY--

• Plan activities to make the most of energy peaks. Frequent rest periods are important. Day-to-day fluctuations in symptoms are common.
• Avoid strenuous activities and needless exposure to the sun or to cold weather.

DIET--No special diet. Soft diet may be necessary if chewing and swallowing are difficult.

Call Your Doctor If

• You have symptoms of myasthenia gravis.
• You develop swallowing or breathing difficulty. You should have emergency medications (anticholinesterase drugs) available at all times to use if symptoms develop.