Myasthenia Gravis Treatment


Myasthenia Gravis TreatmentMyasthenia gravis Treatment – What is Myathenia gravis? Myasthenia gravis is an autoimmune condition that is diagnosed when there is a weakness and rapid fatigue of the muscles under a person’s voluntary control. These symptoms are caused by a breakdown in the communication between the nerves and the muscles.

Signs and symptoms may include:

  • weakness of arm or leg muscles
  • double vision
  • drooping eyelids
  • difficulties with speech,
  • difficulties with chewing,
  • difficulty swallowing
  • difficulty breathing

Though this disease can affect people of any age, it is more common in women under 40 and in men over 60.

More about the symptoms
Muscle weakness caused by Myasthenia gravis increases as the affected muscle is used. As symptoms usually improve with rest, muscle weakness can come and go. However, the symptoms tend to progress over time, usually reaching their worst a few years after the start of the disease.
Some muscle groups are more commonly affected than others:

Eye muscles
In more than 50% of people who develop Myasthenia gravis, their first sign involves eye problems, such as:

  • Drooping of one or both eyelids (ptosis)
  • Double vision (diplopia), which may be horizontal or vertical, and improves or resolves when one eye is closed

Face and throat muscles
In about 15% of people with Myasthenia gravis, the first symptoms involve face and throat muscles, which can:

  • Impair the sound of speech
  • Cause difficulty swallowing
  • Affect chewing|
  • Change facial expressions

Neck and limb muscles
Myasthenia gravis can also cause weakness in your neck, arms and legs. Weakness in the legs can affect walking and weak neck muscles make it hard to hold up the head.

Antibodies
The nerves communicate with the muscles by releasing chemicals called neurotransmitters that fit perfectly into receptor sites on the muscle cells at the nerve-muscular junction.

In Myasthenia gravis, the immune system produces antibodies that block or destroy many of the muscles’ receptor sites for a neurotransmitter called acetylcholine. With fewer receptor sites available, the muscles receive fewer nerve signals, rwhich results in weakness.

Antibodies can also block the function of a protein called tyrosine kinase, which is involved in forming the nerve-muscular junction. Antibodies that block this protein can lead to Myasthenia gravis.

Thymus gland
The thymus gland is a part of the immune system and is situated under the breastbone. Researchers believe that the thymus gland triggers the production of the antibodies that block acetylcholine.

In some adults with Myasthenia gravis, the thymus gland is abnormally large.

Other causes
Some people have Myasthenia gravis that isn’t caused by antibodies blocking acetylcholine or the muscle-specific receptor tyrosine kinase. This type of Myasthenia gravis is called antibody-negative Myasthenia gravis. Antibodies against another protein, called lipoprotein-related protein 4 can play a part in the development of this autoimmune condition.

Factors that can worsen Myasthenia gravis

  • Fatigue
  • Illness
  • Stress
  • Some medications — such as beta blockers, quinidine gluconate, quinidine sulfate, quinine, phenytoin, certain
  • anaesthetics and some antibiotics
  • Pregnancy
  • Menstrual periods

Other disorders
People with Myasthenia gravis are more likely to have other autoimmune conditions such as Lupus, Rheumatoid Arthritis or Thyroid issues.

Myasthenis gravis Treatment by Orthodox Medicine
The first medication used for Myasthenia gravis is usually pyridostigmine, which helps electrical signals travel between the nerves and muscles. It can help reduce muscle weakness, but the effect only lasts a few hours so needs to be taken several times a day. For some people, this is the only medication they need to manage their symptoms. Possible side effects include stomach cramp, muscle twitching, diarrhoea and nausea.

If pyridostigmine does not help or only provides short-term relief, steroid medication such as prednisolone mat be prescribed. These work by reducing the activity of the immune system, to stop it attacking the communication system between the nerves and muscles.

If steroids are not controlling the symptoms or steroids cause significant side effects, different medication may be given that reduces the activity of your immune system, such as azathioprine or mycophenolate. Side effects can include an increased risk of getting infections, feeling and being sick, loss of appetite and tiredness.

Surgery to remove the thymus gland, known as a thymectomy, may sometimes be recommended. This has been shown to improve Myasthenia symptoms in some people with an unusually large thymus, although not in people with a thymus that’s grown abnormally (a thymoma).

Some people with Myasthenia gravis have periods where their symptoms get suddenly worse – for example, they may experience severe breathing or swallowing problems. These potentially life-threatening symptoms, known as a mysathenic crisis, require urgent treatment in hospital.
Treatment may include:

  • oxygen through a face mask
  • using a ventilator
  • intravenous immunoglobulin therapy – a treatment made from donated blood, which improves muscle strength by
  • temporarily changing how the immune system works
  • plasmapheresis – where the blood is circulated through a machine that filters out the harmful antibodies that are
  • attacking the communication system between the nerves and muscles

Natural Myasthenia gravis Treatment

At our Guardian featured clinic, we seek to diagnose and address the underlying issues that are disrupting immune function and thereby causing this stressful condition. We use functional medicine tests and natural medicine, licensed by the UK Government. We treat the patient and not the disease.

There are usually several issues adversely affecting immune function. We need all parts of your health jigsaw to get the whole picture. Tests are carefully chosen for each patient – we do not have a one size fits all approach. A treatment plan is then formulated based on the patient’s test results in order to meet each patient’s unique needs. Patients report that this approach works best.

References

Myasthenia gravis: subgroup classification and therapeutic strategies. Gilhus NE, Verschuuren JJ.Lancet Neurol. 2015 Oct;14(10):1023-36. doi: 10.1016/S1474-4422(15)00145-3.PMID: 26376969 Review.
Maintenance immunosuppression in myasthenia gravis. Gotterer L, Li Y.J Neurol Sci. 2016 Oct 15;369:294-302. doi: 10.1016/j.jns.2016.08.057. Epub 2016 Aug 28.PMID: 27653912 Review.
Current and future standards in treatment of myasthenia gravis. Gold R, Schneider-Gold C.Neurotherapeutics. 2008 Oct;5(4):535-41. doi: 10.1016/j.nurt.2008.08.011.PMID: 19019304 Free PMC article. Review.

Myasthenia and the neuromuscular junction.

Gilhus NE.Curr Opin Neurol. 2012 Oct;25(5):523-9. doi: 10.1097/WCO.0b013e3283572588.PMID: 22892950 Review.

Paraneoplastic syndromes of the neuromuscular junction: therapeutic options in myasthenia gravis, lambert-eaton myasthenic syndrome, and neuromyotonia.

van Sonderen A, Wirtz PW, Verschuuren JJ, Titulaer MJ.Curr Treat Options Neurol. 2013 Apr;15(2):224-39. doi: 10.1007/s11940-012-0213-6.PMID: 23263888

If you would like an appointment for Myasthenia gravis treatment

Contact Deborah’s Medical Secretary for an appointment