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Myasthenia gravis, or myasthenia gravis, is an autoimmune disease that causes progressive muscle weakness, being more common in women and usually begins between 20 and 40 years of age. Symptoms of myasthenia gravis may start suddenly, but they usually start to appear and gradually get worse.
The causes of myasthenia gravis are related to a change in the immune system that causes antibodies to attack certain structures that are fundamental for muscle control.
THE myasthenia gravis there is no definitive cure, but the treatment adapted to each case, with specific remedies and physical therapy exercises, can improve the quality of life.
Possible symptoms
The most common initial symptoms of myasthenia gravis are:
- Eyelid weakness and difficulty opening eyes or blinking;
- Weakness of the eye muscles, which leads to strabismus and double vision;
- Excessive muscle tiredness after exercise or physical effort.
As the disease progresses, symptoms worsen and include:
- Weakness of the neck muscles that hang the head forward or to the side;
- Difficulty climbing stairs, raising arms, writing;
- Difficulty speaking and swallowing food;
- Weakness of the arms and legs, which varies in intensity over hours or days.
In the most severe episodes, there may also be involvement of the respiratory muscles, a condition called myasthenic crisis, which is serious and can lead to death if it is not treated quickly in the hospital.
Symptoms usually worsen with repetitive use of the affected muscle, but it can also happen when you are exposed to heat, when you are under stress or anxiety, or when using anxiolytic drugs or antibiotics.
How the diagnosis is made
Most of the times the doctor is suspicious of the diagnosis of myasthenia gravisthrough the assessment of symptoms, physical examination and study of the person's health history.
However, several tests can be used to screen for other problems and confirm myasthenia gravis. Some of these tests include electroneuromyography, MRI, computed tomography and blood tests.
What causes myasthenia gravis
THE myasthenia gravis it is caused by a change in the immune system that causes some antibodies to attack receptors in the muscles. When this happens, the electrical message is unable to pass correctly from neurons to muscle fibers and, therefore, the muscles do not contract, demonstrating the characteristic weakness of myasthenia.
How the treatment is done
There are several types of treatment that can improve a person's quality of life, depending on the symptoms presented. Some of the most used forms include:
1. Remedies
Medicines are the most used form of treatment, because, in addition to being practical, they have excellent results. The most used types of drugs are:
- Cholinesterase inhibitors, such as Pyridostigmine: improve the passage of the electrical stimulus between the neuron and the muscle, improving muscle contraction and strength;
- Corticosteroids, like Prednisone: decrease the effect of the immune system and, therefore, can reduce various types of symptoms. However, they cannot be used for a long time, as they can have several side effects;
- Immunosuppressants, such as Azathioprine or Ciclosporin: these drugs also reduce the functioning of the immune system, but are used in more severe cases, when symptoms do not improve with other drugs.
In addition to oral remedies, the doctor may also recommend the use of intravenous medication, such as monoclonal antibodies, which reduce the amount of some defense cells in the body, improving the symptoms of myasthenia gravis.
2. Plasmapheresis
Plasmapheresis is a therapy, similar to dialysis, in which blood is taken from the body and passed through a machine that removes excess antibodies that attack muscle receptors, facilitating the passage of the electrical signal between neurons and muscle fibers.
Although it is a treatment with good results, it also has some health risks such as bleeding, muscle spasms and even severe allergic reactions.
3. Surgery
Surgery is a rarer treatment, but it may be necessary when a tumor is identified in an organ of the immune system that is causing the production of antibodies that generate myasthenia gravis.
4. Physiotherapy
Motor and respiratory physiotherapy are also indicated in the treatment of myasthenia gravis in order to strengthen the muscles, improve the range of motion, breathing and prevent respiratory infections.