Myasthenia Gravis

Myasthenia Gravis

  • Author: Dr. Jaime Espino
  • Date: April 15, 2022

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What is Myasthenia Gravis?

Myasthenia gravis is a neuromuscular junction disorder of autoimmune origin, characterized by variable muscle weakness that appears after physical activity and improves with rest.

Only the striated or voluntary muscles are affected, not the involuntary muscles such as those of the heart or intestines.



Symptoms of Myasthenia Gravis:

Symptoms may include:

  • Muscular: Weakness in the arms and legs or general muscle weakness.
  • Facial: Drooping of the upper eyelid or facial muscle weakness.
  • Also common: Difficulty speaking, breathing, or swallowing, fatigue, or double vision.

Requires medical diagnosis

Symptoms include muscle weakness in the arms and legs, double vision, and difficulty speaking and chewing.



Causes of Myasthenia Gravis

The exact cause of this disease is currently unknown, although the presence of anti-acetylcholine receptor antibodies suggests an autoimmune basis.

This means that our own immune system mistakenly identifies components of our body’s tissues as foreign, attacking and destroying them.

The relatively high frequency of thymus involvement (thymoma in 10% of cases and thymic hyperplasia in 70%), as well as the association with other autoimmune diseases and autoantibodies, also supports the autoimmune pathogenesis of this disease.



Types of Myasthenia Gravis

  • Congenital MG. This is a very rare, non-immune form of MG inherited as an autosomal recessive disorder.
  • Transient neonatal MG. About 12 to 20% of babies born to mothers with MG may experience a temporary form of the disease.
  • Juvenile MG.


Diagnosis of Myasthenia Gravis

When myasthenia gravis is suspected based on clinical presentation and physical examination, the diagnosis must be confirmed with complementary tests such as:

  • Administration of anticholinesterase drugs. The edrophonium (Tensilon®) test produces a rapid antimyasthenic effect.
  • Electrophysiological studies. Two tests are used: repetitive stimulation testing (77% sensitivity) and single-fiber electromyography (92% sensitivity).
  • Detection of anti-acetylcholine receptor antibodies. Positive in up to 50% of patients with ocular myasthenia and in 75% of those with generalized myasthenia.

A thymus tumor (thymoma) should always be ruled out through CT or MRI scans, along with evaluating thyroid function and screening for other autoimmune diseases.



Treatment for Myasthenia Gravis

  • Treatment consists of steroids.
  • Medications, therapy, and surgery can help.
  • Blood transfusions, muscle strengtheners, and steroids.
  • Thymectomy.


Complications of Myasthenia Gravis

The most serious aspect of myasthenia occurs when weakness affects the respiratory muscles. In such cases, shortness of breath and acute respiratory failure may occur, potentially requiring hospitalization. This condition is called a myasthenic crisis.



Prevention of Myasthenia Gravis

Can it be prevented? Currently, there is no known way to prevent myasthenia gravis, as the specific causes of this autoimmune disease are still unknown.



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