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Myasthenia gravis begins in a harmless way: e.g. with drooping eyelids or muscle fatigue. Such symptoms often portend myasthenia gravis, a disease that plagues mainly young women. Myasthenia gravis is an autoimmune disease that affects the muscles. What are the causes of myasthenia gravis? What is its treatment?
In Polandmyasthenia gravisaffects over three thousand people. Every year, another 150 - 200 are diagnosed. Mainly women in their twenties and thirties are ill. Myasthenia gravis also attacks men, but less frequently and usually at a later age.
The firstsymptoms of myasthenia gravisoccur in 65-70 percent. sickdrooping eyelids . The muscles that move the eyeball and support the eyelids are so weakened that the eyelids droop. Double vision is also characteristic, especially dangerous when, for example, someone is driving a car. Half of the sick will have only such symptoms for the rest of their lives. Unfortunately, other muscles are also affected by myasthenia gravis.
Myasthenia gravis - symptoms
When the myasthenia gravis affects the muscles of the pharynx, larynx, or oral cavity, not only speech disorders occur. It is then also difficult to bite, chew and swallow bites of food. When the respiratory muscles are involved, the patient cannot gasp and is at risk of respiratory failure.
When the muscles of the arms and legs are affected, every movement and step is difficult. Myasthenia gravis is excessive muscle fatigue after exercise, even if it is slight. Sometimes a rest is enough to make them fit again. Symptoms of the disease do not occur after a night's rest in the morning. They worsen in the evening, when patients are tired of everyday activities.
- Myasthenia gravis sometimes retreats for many years, these are periods of the so-called remission - explains Dr. Maria Strugalska from the Muscle Disease Clinic in Warsaw. In about 10-15 percent of cases, the disease goes away on its own. Unfortunately, it can also develop slowly all the time. Symptoms worsen for any reason, such as infection, excessive heat or cold, physical exhaustion, stress, untreated hyperthyroidism or hypothyroidism, low levels of potassium in the body after vomiting or diarrhea.
In women during menstruation or at the beginning of pregnancy. The disease affects only skeletal muscles.It does not attack smooth muscles, i.e. the intestines, bladder, uterus, and heart muscle. So, for example, the heart does not stop beating, and women suffering from myasthenia gravis can give birth by force of nature.
ImportantMyasthenia gravis is treated by a neurologist. When we come to him with a suspicion of this disease, he will order additional tests after an interview. First - blood analysis for the presence of antibodies to acetylcholine receptors. Then for electromyography (assesses the strength and fatigue of the muscles after irritation of the nerve with a weak current) and computed tomography of the mediastinum (assesses the size and condition of the thymus gland). Usually, a specialist also orders the determination of the level of thyroid hormones, because quite often myasthenia gravis is accompanied by an overactive gland.
Myasthenia gravis - causes
Myasthenia gravis is not inherited. Instead, it is an autoimmune disease. This means that the immune system produces antibodies that are directed against its own cells and tissues.
In the case of myasthenia gravis - against the receptors on the muscle fibers. Autoantibodies block these receptors and prevent the attachment of acetylcholine (a substance that is classified as neurotransmitter) released by nerve fibers. Then there is no transmission of information between the nerve and the muscle, and therefore the muscle cannot contract and then no movement can be made.
We don't know the causes of myasthenia gravis. It is not known why some people form autoantibodies. They are known to be produced in the thymus gland. Normally, this gland next to the thyroid gland disappears after adolescence. In patients with myasthenia gravis, the thymus still exists. Sometimes (about 15% of cases) it grows a tumor - thymoma.
Myasthenia gravis - treatment
- Patients with thymoma have their thymus removed - says doctor Maria Strugalska. - The operation is called a thymectomy. It is also performed when the symptoms of myasthenia gravis are severe and are getting worse despite taking medications. After thymus removal, the myasthenia gravis disappears in approximately 30 percent of patients. Another 50 percent of people treated with surgery improve significantly. For others, immunosuppressive treatment, the so-called chemistry, i.e. the administration of drugs used in oncology.
In the initial stage of the disease (and if there is no thymic tumor), doctors usually prescribe drugs that facilitate the transmission of impulses from the nerve to the muscle, e.g. polstigmine, mestinone, mytelase. It is extremely important to choose the right dose and take it at a strictly specified time. The point is to prevent the so-called a cholinergic crisis, i.e. exacerbation of symptomsdiseases.
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