Myasthenia Gravis: Symptoms, Causes, diagnosis and treatment.

1. Myasthenia Gravis CAUSES | SYMPTOMS | DIAGNOSIS | TREATMENT

2. Introduction to Myasthenia Gravis • Myasthenia Gravisis a neuromuscular disorder primarily characterized by muscle weakness and muscle fatigue. Although the disorder usually becomes apparent during adulthood, symptom onset may occur at any age. • The condition may be restricted to certain muscle groups, particularly those of the eyes (ocular myasthenia gravis), or may become more generalized (generalized myasthenia gravis), involving multiple muscle groups. • Most individuals with myasthenia gravis develop weakness and drooping of the eyelids (ptosis) weakness of eye muscles, resulting in double vision (diplopia) and excessive muscle fatigue following activity.

3. Causes of Myasthenia Gravis • Myasthenia Gravis is a neuromuscular disorder that is usually caused by an autoimmune problem. • Autoimmunedisorders occur when the immune system mistakenly attacks healthy tissue. • In this condition, antibodies (proteins which normally attack foreign, harmful substances in the body) attack the neurotransmittersubstance called acetylcholine, which is a crucial substance for nerve cell and muscle communication. • This results in the muscle weakness that characterizes the condition. The exact cause of this autoimmune reaction is unclear to the doctors.

4. Symptoms of Myasthenia Gravis Symptoms may include: • Trouble talking • Problems walking up stairs or lifting objects • Facial paralysis • Difficulty breathing because of muscle weakness • Difficulty swallowing or chewing • Fatigue • Hoarse voice • Drooping of eyelid • Double vision

5. Diagnosis of Myasthenia Gravis Your doctor will perform a complete physical exam, as well as take a detailed history of symptoms. He or she will also do a neurological exam. This may consist of: Checking your reflexes • Looking for muscle weakness • Checking for muscle tone • Making certain your eyes move properly • Testing sensation in different areas of your body • Seeing if you can perform certain movements, like touching your finger to your nose

6. Diagnosis Continue… Other tests that can help your doctor diagnose the condition include: • Repetitive nerve stimulation test • Blood testingfor antibodies associated with Myasthenia Gravis • Edrophonium (Tensilon)test: a drug called Tensilon (or a placebo) is injected, and the patient is asked to perform muscle movements under doctor observation • Imaging of the chest, using CT scansor MRI, to rule out a tumour

7. Treatments of Myasthenia Gravis Common treatments for myasthenia gravis include: • Medicationssuch as Mestinon (pyridostigmine bromide) and Prostigmin (neostigmine bromide) • Corticosteroid medications such as prednisone • Medications that suppress the immune system, such as Imuran (azathioprine) and cyclosporine • Removal of the thymus gland (thymectomy), the main gland in the immune system • Plasma exchange (plasmapheresis), in which the person's blood plasma containing the abnormal antibodies is removed and fresh plasma is put back

8. Preventions of Myasthenia Gravis Myasthenia gravis cannot be prevented, but avoiding the following triggers may help patients prevent exacerbation: • Emotional stress • Exposure to extreme temperatures • Fever • Illness (e.g., respiratory infection, pneumonia, tooth abscess) • Low levels of potassium in the blood (hypokalemia; caused by diuretics, frequent vomiting) • Medications (e.g., muscle relaxants, anticonvulsants, certain antibiotics) • Overexertion