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Myasthenia Gravis Prognosis and Treatment

myasthenia-gravis

by Robert M. Pascuzzi, M.D.

Q. I would like to know the most recent information you have concerning myasthenia gravis, as our older sister has had this disease since I was 15. How does this disease affect a person as they become older? She has had her thymus gland removed.

This is a strange disease of which few specialists are available. The neurology doctors don’t really like to deal with it much. Also, I know one woman who was diagnosed with this disease at 75. Amazing it strikes at that older age when my sister was 18.
—Belinda, Mississippi


A.
Prior to 1950, this autoimmune disease was often fatal. What a difference a few decades make. Today, most people are diagnosed early, and treatment is typically effective.

newsletter-graphicSince only one in 10,000 people has myasthenia gravis, I can understand why your sister has had trouble finding doctors who specialize in it. I will try to shed some light. Myasthenia gravis, in fact, represents one of the best-understood and most treatable conditions in neurology.


What Is Myasthenia Gravis?
Myasthenia gravis is an immune-system disorder that causes fluctuating weakness. Normally, your body produces antibodies that help get rid of bad guys like bacteria and viruses. With myasthenia gravis, the antibodies get confused and attack muscles, interfering with your nerves’ ability to communicate with them. We don’t know why this happens.

Initial symptoms are often droopy eyelids and double vision. Many people eventually experience slurred speech, trouble chewing and swallowing, and variable degrees of arm and leg weakness. The symptoms can be mild or life-threatening, especially if it severely affects your breathing and swallowing muscles.

This disease can strike anyone from children to the elderly. Commonly, women get it in their 20s or 30s, and men get it in their 50s or 60s. Symptoms come and go. You may have periods when you’re relatively normal and periods of significant weakness. Sometimes, an infection or a new medication can trigger a flare-up.

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Myasthenia Gravis Prognosis and Treatment

People usually do better and better over many years. If you’ve been stable for a decade or so, you have an excellent chance of remaining that way.

Fortunately, myasthenia gravis is treatable. Most people improve with medicines called cholinesterase inhibitors, such as pyridostigmine (Mestinon). These help the muscles get the nerve signals.

For many people with more severe disease, drugs that suppress the immune system are effective. These include prednisone and azathioprine (Azasan, Imuran). As you might imagine, taking such drugs comes with precautions your doctor will tell you about.

Some people require plasma exchange, in which they get the damaging antibodies literally washed out of the bloodstream.

Administering normal antibodies called gamma globulin has proven to be a valuable treatment strategy.

And there has been longstanding interest in the role of thymus-gland removal since the thymus is connected with the immune system. You can do without it because after the first few years of life, it’s no longer necessary for normal immune-system function.

The point is, multiple effective forms of treatment are available, and most people should expect to do pretty well over the long-term.


Board-certified neurologist ROBERT M. PASCUZZI, M.D., is a professor and chair of neurology at Indiana University School of Medicine and a neurologist with Clarian Neuroscience, which offers neurological services at three hospitals in Indiana. He’s also chairman of The American Board of Psychiatry and Neurology and past-chair of the Myasthenia Gravis Foundation of America’s Medical and Scientific Advisory Board.


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Last updated and/or approved: July 2011. Original article appeared in May/June 2009 former print magazine. Bio current as of that issue. This general health-care information is not meant as individual advice. Please see our disclaimer.
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Myasthenia gravis
written by Cathy blackwood , March 25, 2017

My mother had this for almost 7 years. She was miserable every day. She had fatigue, droopy eyes, diarrhea from the mestinon. She rarely could leave home. Weakness was very prevalent she lived to be 92 but she lost her battle, when her heart gave out, her breathing got hard, she had no appetite
This disease much research to find something to make their lives better. My mothers quality of life at the end needed help.

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written by jen , August 06, 2015

Not easily diagnosed, or treated, its a painful, awful disorder...it affects my daily life, I can't hold my own eyes open, some days I have to use a wheelchair if I even want out if my home I choke, slur, and my arms and legs are in constant pain....this doc acts like its a cold or something.. This is a disease I wouldn't wish on anybody..
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written by Donna Hopson , August 19, 2013

I have been taking Mestinon only for 2 weeks now and have managed to stop the stomach problem by taking Probiotics and Psyllium Husk before I take the tablet. I have also manged to stop the cramps in my legs by taking a combination tablet of Magnesium, Calcium and pottasium [it's only one tablet at a time and works wonders along with stretching.
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written by Bernie , May 19, 2013

Can this disease be localised to the speech been effected?
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myasthenia
written by Lilly Monks , May 08, 2013

I found some symptoms of myasthenia like diplopia, leg weakness. I consult with my family doctor, and as he prescribed Mestinon medication have been taking and notice the improvement right away.
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Myasthenia gravis
written by Rocie Daniels , February 22, 2013

This disease cause you muscles to weaken and it is harder for you to control them
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