Myasthenia gravis

Myasthenia gravis is one of the most common diseases associated with disruption of nerve and muscle cells.

Symptoms:

• the eyelid droops
• Objects begin to double
• It becomes harder to speak and swallow
• It's hard to chew
• the neck muscles weaken — sometimes so much that a person cannot keep his head straight (drooping head syndrome)
• weak arms and legs — it can be difficult to climb the stairs, get up from squatting or just keep your hands up

The peculiarity of this disease is that the symptoms change during the day: in the morning it is usually easier for a person, and by the evening the condition worsens.

Myasthenia gravis refers to relatively rare diseases. It is estimated that the average primary incidence in Russia is about 5-10 people per 100,000 population per year.

The disease can begin at any age — from early childhood to old age. But there are two pronounced peaks. The first one is 20-40 years old, while for women it is about 26 years old, for men it is 31 years old. The second peak is observed after 50-60 years. In recent decades, doctors have noted an increase in the number of cases in the older age group, partly due to the fact that the diagnosis has become better. 

In young and middle age (with early onset), myasthenia gravis is noticeably more common in women — the ratio is approximately 1:3 (that is, there are three times more women than men). But after 50-60 years, gender differences are smoothed out: the incidence becomes approximately the same for men and women. 

Myasthenia gravis occurs due to a malfunction in the immune system: the body mistakenly produces antibodies that interfere with muscle function.
In 75-85% of cases, these antibodies are directed against special receptors (acetylcholine). To find out if there are such antibodies, you can take a blood test.

To understand how impaired the transmission of signals from nerves to muscles is, a special study is conducted — a decrement test.

Sometimes it shows the norm even with myasthenia gravis — in such rare cases, another research method is used, the so-called jitter test: it helps to identify the disease in 96% of cases.

The most dangerous complication of myasthenia gravis is myasthenic crisis: due to severe weakness, breathing problems may occur. 

It is really possible to live with myasthenia gravis fully: although this is a chronic disease and it cannot be completely cured, proper therapy helps to bring the symptoms under control and achieve lasting remission. 

Symptomatic therapy.
Its goal is to quickly improve neuromuscular transmission and remove weakness. Anticholinesterase drugs are often prescribed.

Pathogenetic therapy.
It is aimed at the very mechanism of the disease — an autoimmune attack. These include glucocorticoids, immunosuppressants, monoclonal antibody-based drugs, intravenous immunoglobulins (IVIG). 

Plasmapheresis is also performed. In case of severe course or crisis, this procedure is carried out to clear the blood of pathological antibodies. 

Surgical treatment. 
It's about thymectomy — removal of the thymus gland (thymus). This is especially true if myasthenia gravis is associated with a thymoma (tumor of the thymus).

• But the operation may be considered in other cases: with a generalized form, inefficiency of drugs, increasing weakness. After thymectomy, some patients' condition improves and the need for medication decreases. 

Rehabilitation includes physical therapy, physiotherapy (electrophoresis, electromyostimulation), breathing exercises.

The MCSC named after A.S. Loginov employs a team of highly qualified doctors of various specialties to treat such patients.

Make an appointment for a consultation with a neurologist at the Center for Neuromuscular Pathology (CNMP).

• Our phone: +7 (495) 304-30-39