Myasthenia Gravis

Myasthenia Gravis is an autoimmune disease. In autoimmune diseases, the defense mechanism of body starts to destroy its own tissues. These diseases are more common in females.

Symptoms:

Symptoms include drooping of eyelids, double vision, difficulty in eating food, nasal regurgitation of food, difficulty in talking, getting up from the sitting position and climbing stairs. Symptoms are worse in evening hours. Patient is better in morning hours.

Treatment and recovery:

The principle of treatment of myasthenia gravis is slowing down the defense system of body. Steroids along with other drugs are usually given. Treatment has to be continued for years and sometimes for lifetime. Sometimes the disease gets worse and the patient may need admission in hospital or ICU. In such cases, patients may need plasmapheresis or IVIG.

Thymectomy:

Thymectomy is the surgical procedure. It involves removal of gland from front of chest. It is recommended in most but not all patients of myasthenia gravis. This can cure almost half of patients and in others it can decrease disease severity significantly.

Pregnancy and delivery:

Since this disease is more common in females, therefore, pregnancy and delivery issues need to be highlighted. Since this disease is autoimmune, drug treatment may need to be given for years. It very important for female patients to discuss with doctors about their marriage, well in advance (if previously unmarried) and also share childbearing plans. Many drugs that are used in the treatment of myasthenia gravis are harmful for the pregnancy. The doctor may advise alternative drugs and discontinue harmful drugs. Whatever drugs the doctor prescribes, you need to take them continuously throughout the pregnancy and afterwards. Some patients who undergo C-section for childbirth may have some difficulty recovering from general anesthesia. Patient should inform her gynecologist about her disease beforehand.

Frequently Asked Questions

Do I need physiotherapy?

Physiotherapy is generally not necessary,however, staying active is highly recommended.

Can I do job?

Yes, you can opt any profession like healthy persons but it should not involve physical labour or exposure to chemicals.

Should I avoid certain medications?

Some medicines make myasthenia gravis worse. If the patient of myasthenia gravis has to take medicine for some other medical condition like fever, sore throat, flu, hypertension etc., treatment should be sought from competent medical practitioner. Doctor should be informed beforehand about myasthenia gravis.

What is the duration of treatment?

Since this is an autoimmune process, treatment needs to be given for years and may be lifetime. Some patients can get cure with thymectomy and in these patients drug treatment is discontinued.

Can I conceive and have baby?

Yes, you can but you need to discuss it with your doctor beforehand. Doctor may discontinue some drugs or change the drugs.

Will my kids inherit this disease?

Myasthenia Gravis is not an inherited disease.

What are the general precautions I need to observe?

Patient suffering from myasthenia gravis should pay special attention to their health. They should take balanced diet and should walk or workout appropriate for their age.

Do I need preventive vaccines?

It is recommended that myasthenia gravis patients receive pneumonia shots every 3 years and flu shot every year in September.

Can I undergo any surgical procedure?

Yes but you need to inform your doctor about disease beforehand. At times, there can be some problems with anesthesia.

I am taking steroids, what precautions I should consider as a diabetic?

If you are taking steroids and if you are diabetic then you need to see  your diabetologist more frequently. Steroids cause raise in blood sugar. Better glycemic control is required. While on steroids, you need to limit your salt intake. You also need to take calcium and vitamin D supplement, ask your doctor about it. Steroids cause weight gain, so limit your caloric intake and stay active. Steroids also make you prone to contagious diseases so practice necessary precautions. Steroids can cause skin bruises, if you notice any, consult your doctor.

Disclaimer:
The information given here is intended for use of general public . It should not be taken as standard medical reference.

About the Author:

One of the most well known neurologists in Lahore, he is serving as Assistant Professor of Neurology at Lahore General Hospital. He is a graduate of King Edward Medical College and did residency in general medicine & neurology at Mayo Hospital Lahore. He did FCPS in neurology and moved to Lahore General Hospital, and has been working there since.

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