Myasthenia gravis is an autoimmune disorder that causes weakness in the skeletal muscles. Patients with this neuromuscular disorder can have several types of symptoms, such as difficulty breathing, swallowing and climbing stairs, as well as double vision and facial paralysis.
These symptoms result from the immune system producing antibodies that block or damage the acetylcholine receptors in the neuromuscular junction. MedlinePlus noted that no cure for myasthenia gravis exists, though the treatments for the disorder can extend periods in which the patient does not have symptoms.
One treatment option for myasthenia gravis is medication. Medications such as anticholinesterase agents help with neuromuscular transmission. Examples of anticholinesterase agents include pyridostigmine and neostigmine.
By improving the communication between the muscles and the nerves, these medications can help increase the patient’s muscle strength. Side effects of these medications include frequent urination and gastrointestinal upset.
Another option for medication is immunosuppressive drugs. As myasthenia gravis is an autoimmune disorder, this type of medication works by suppressing the immune system’s production of the antibodies that affect the acetylcholine receptors in the neuromuscular junction. Examples of immunosuppressive drugs for myasthenia gravis include tacrolimus, prednisone, mycophenolate mofetil, azathioprine and cyclosporine.
While these immunosuppressive drugs can help reduce symptoms, the National Institute of Neurological Disorder and Stroke warned that they can cause major side effects, such as liver damage and infertility, and must be monitored closely by a physician.
Corticosteroids also suppress the immune system and can help with the symptoms of myasthenia gravis, though these medications can cause diabetes, bone thinning, and an increase and redistribution of the patient’s body fat.
Surgery is another treatment option, especially for patients who have a tumor in their thymus gland, which is about 15 percent of myasthenia gravis patients, according to the MayoClinic.com. The removal of the thymus gland may rebalance the immune system of some patients.
Some patients will not qualify for surgery. These include patients who are older than 60, have mild symptoms, or only experience symptoms in their eyes.
Different therapies may also help with the symptoms of myasthenia gravis. One example is plasmapheresis, in which the patient’s blood is filtered through a machine to remove the antibodies involved in the disorder. The MayoClinic.com noted that the benefits of this therapy only lasts a few weeks and over time, it can be difficult to access the patient’s vein.
Another therapy is intravenous immune globulin, which gives the patient’s body normal antibodies. While this therapy has fewer risks of side effects compared to immunosuppressive drugs and plasmapheresis, patients may not experience improvements for a week or two.
References
MedlinePlus Medical Encyclopedia. Myasthenia Gravis. Web. 19 October 2011
http://www.nlm.nih.gov/medlineplus/ency/article/000712.htm
MayoClinic.com. Myasthenia Gravis. Web. 19 October 2011
http://www.mayoclinic.com/health/myasthenia-gravis/DS00375/METHOD=print
National Institute of Neurological Disorders and Stroke. Myasthenia Gravis Fact Sheet. Web. 19 October 2011
http://www.ninds.nih.gov/disorders/myasthenia_gravis/detail_myasthenia_gravis.htm
Reviewed October 19, 2011
by Michele Blacksberg RN
Edited by Jody Smith