Myasthenia Gravis

Articles

Jun 1

A result of neurological and immune dysfunction, myasthenia gravis affects voluntary muscles throughout the body. The communication between from the brain to the muscles is interrupted and therefore unable to send normal transmissions to make muscles move. Over time, muscles do not get as much activity and begin to fatigue rapidly. Myasthenia gravis can affect any muscle grouping including muscles in the face affecting vision, speech, and even breathing. Although symptoms may progress quickly, treatment is possible to help manage symptoms and adjust an individual’s lifestyle to better suit changes in their abilities. Although this disorder is not extremely prevalent, occurring in approximately 20 in 100,000 individuals in the US, it is believed that many cases are never diagnosed.

What Causes Myasthenia Gravis?

Because myasthenia gravis affects the neuromuscular connection, the cause is related to the body’s immune response to the neurotransmitters released by the brain. An individual’s immune system blocks the neurotransmitters from reaching the muscles often by destroying the receptor sites on the muscles. As this continues, muscles are not triggered or used as much and begin to grow weak. The reason for this immune response is not understood.

This autoimmune disorder is sometimes related to an enlarged thymus gland, which is found under the sternum. The thymus gland produces the antibodies which block and destroy neurotransmission. In rare cases, children are born with myasthenia gravis but generally are able to recover shortly after birth. Typically, this disorder is not inherited, although it can occur in multiple members of the same family. There is no indication that myasthenia gravis is contagious or transmitted through any form of contact.

Symptoms of Myasthenia Gravis

Many individuals first notice symptoms of myasthenia gravis in their eyes, either experiencing double-vision or drooping eyelids. The muscles in the face are often the first affected muscle groupings by this disorder, which can affect an individual’s ability to speak, eat, or even smile. Aside from the muscles in the face, myasthenia gravis may also affect the areas of the neck, arms, or legs. It can make a simple action such as lifting your head very difficult. As symptoms progress, an individual might struggle to breathe, walk, use their hands, or see. Any of these symptoms should be reported to healthcare providers as soon as possible to potentially prevent any progression.

There are some factors which might make symptoms of myasthenia gravis worse. Surgery, illness, infection, or fatigue can have a negative effect on individuals with this disorder. Pregnancy, menstruation, and stress also require the body to work harder, and in turn, worsen myasthenia gravis. At times, individuals are in need of medical attention to prevent a life-threatening condition, particularly when breathing becomes difficult.

Treatment of Myasthenia Gravis

After diagnosis, treatment plans may follow many different paths. Factors such as age, progression rate, and severity typically determine the course of action. Sometimes individuals will be prescribed medications such as immunosuppressants to help manage symptoms or prevent progression. In a process called plasmapheresis, blood is processed through a machine similar to dialysis and the offending antibodies are removed. In some cases, healthcare providers may recommend surgery to extract the thymus gland and halt production of the antibodies which affect the muscle’s receptor sites.

As with many other disorders which result in a change to an individual’s ability, adjustments to routine and overall lifestyle are typically necessary. Many individuals will choose to work with occupational, physical, or speech therapists to help them adjust and engage their life with as much independence as possible. Occupational therapists can assess the home setting and make recommendations to the environment to better suit the abilities of the individual. This might include adding assistive equipment or devices, learning strategies to complete activities of daily living (ADLs) in a new way, or learning techniques or routines to maintain existing abilities. Physical therapists can also assist an individual to help them learn how to use assistive equipment such as a wheelchair, or recommend specific strengthening exercises to utilize the unaffected muscles and strengthen the body. Speech-language pathologists can address issues related to chewing, swallowing, speaking, and using facial muscles. They may recommend devices or methods to promote better nutrition or health along with lifestyle adjustments to help individuals gain their maximum level of independence.

Supporting Individuals with Myasthenia Gravis

Although these physical changes to an individual’s abilities are somewhat out of their control, what they can control is their stress level. Keeping stress levels down will help prevent the condition from worsening. It is important that loved ones and families have an understanding of what this disease is and how it affects an individual, because like so many autoimmune disorders, it may seem invisible. For many people, support groups for any member of the family can help them feel less alone.

If you know a family member or loved one who may have myasthenia gravis, help them by beginning to keep track of any noticed symptoms. Make a list of when they first occurred and how they have progressed. Any information can be helpful for your healthcare professional, such as any indication of what makes the condition better or worse. If you have already been diagnosed and would like an assessment from an occupational, physical, or speech therapist, contact the team at Tilton’s Therapy. Our exceptional team of therapists work with patients of all ages and can provide therapeutic intervention to help those you love live their life to its fullest potential. Because we provide mobile therapy, we are able to address needs of the individual in their natural environment, which provides an opportunity to involve the whole family.

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