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Myasthenia gravis 

Myasthenia gravis 

Myasthenia gravis is an autoimmune ,neuromuscular disorder ,as the name suggest this condition is related to nerves and muscles 

This condition occurs when the communication between the nervous system and muscular system impaired,as a result it leads to weakness in the muscles of the body 

 

Risk factors

    • Age -it mainly affect the young adult women(under 40 )and older men(over 40)
    • Family  history -people who have a family history of myasthenia gravis and other autoimmune disorder are prone to myasthenia gravis.
    •  Environmental factors - such as sedentary lifestyle ,smoking eating more junk food all these factors weaken the immune system

 

  • Neonatal myasthenia gravis - in neonatal myasthenia may  acquire immune proteins from a mother affected with myasthenia gravis 

 

 

Complication

 

One of the major complications of myasthenia gravis is

  •  myasthenia crisis,it is life threatening muscle weakness that can include breathing problems
  • Thymus tumors
  • In Myasthenia gravis , people are more prone to develop thyroid autoimmune conditions such as rheumatoid arthritis and lupus 



Symptoms 

Myasthenia gravis is wide range of symptoms such as :

  • In some people only the eye muscles will be affected while in other it could symptoms in many muscles ,including those that control breathing.
  • The most prevent symptom is fatigue 
  • Difficulty in swallowing -the person may choke easily ,and eating and drinking and swallowing pills become harder.
  • Impaired speech (dysarthria) - speech may become soft or narrow
  • Difficulty in chewing -the muscles which is used for chewing may weaken and cause difficulty during eating if the food harder
  • Facial expression -a change in facial expression ,a different or unusual smile may develop if certain facial muscles are affected
  • Shortness of breathing
  • Weakness in the arms ,hands,feet,fingers,and neck it lead to trembling of the hands.

 

  • Ocular myasthenia gravis -the muscles which control the eyes it also affect ,become weak and cause various symptoms such as
  •  dropping of one or both eyelids (ptosis)
  • Blurred vision or double vision (diplopia),all these symptoms create problems in eyesight .

 

  • When the limbs muscles are involved other muscles also tend to be affected such as throat,eyes or face.

 

All these symptoms become progressively worsen during activity,but symptoms improve after resting. 

 

Causes

 

Myasthenia gravis is a neuromuscular disorder that’s usually caused by autoimmune problems,the exact cause of this autoimmune reaction is not clear yet property but may be viral or bacterial proteins may prompt the body to attack acetylcholine

Autoimmune disorder means when your immune system ,which normally protect the body from foreign organisms -mistakenly attacks itself

 

In this condition antibodies, which are proteins that normally attack foerign,harmful substances in the body,attack the neuromuscular junction.when it gets damaged ,as a result ,neuromuscular membrane reduces the effect neurotransmitter substance acetylcholine,which is a crucial substance for communication between nerve cells and muscle.this results in muscle weakness and finally muscle cannot contract properly,and they easily become tired and weak.

Thymus gland - thymus gland situated in the upper part of chest ,researchers believe the thymus gland triggers or maintain the production of antibodies that block acetylcholine

 

Diagnosis and treatment

 

Diagnosis

 

The diagnosis is made by

  1.  physical examination and neurological examination
  2. Some tests such as blood and nerve test
  3. Scanning -CT and MRI
  4. A detailed case history also help in diagnosis
  5. Edrophonium test ( tensilon)



Physical examination

This step includes some some neurological examination ,the physician will check muscle strength and tone ,coordination,sense of touch,and look for impairment of eye movement,your reflexes.

 

Blood and nerve test

The main test for myasthenia gravis is blood test and this test is done to identify the presence of acetylcholine receptor antibodies.(produced by the immune system)-a high level of these antibodies usually means you have myasthenia gravis

Nerve test -if the blood report is normal but there is doubt for the myasthenia gravis persist ,this test is recommended theses test known as electromyography, this test measures the electrical activity in them.

 

Scan -CT scan and MRI of the chest this test is performed to know the status of thyroid gland because the thyroid gland is closely associated with myasthenia gravis or to rule the tumour.

 

Edrophonium test- a drug or a placebo is inserted intravenously, and you are asked to perfume muscles movements under doctor observation

 

Treatment 

The main aim of treatment is to manage the symptoms and control the activity of your immune system.

  • Medication -corticosteroids and immunosuppressants are used to suppress the immune system ,cholinesterase inhibitors
  • Surgery - Thymus gland remove which is part of the immune system ,once the thymus removed, patients typically show less muscle weakness.
  • Plasma exchange -this process removes harmful antibodies from the blood ,which may result in an improvement in muscle strength.

But all these treatment are conventional and permanent 



Management 

 

The best way to get rid of this condition is to manage the case

  • Take rest as much as possible to minimise the muscles weakness
  • If you are suffering from double vision u can consult with your doctors and take advice for an eye patch.
  • Avoid stress and heat exposures ,as both can worsen symptoms.
  • Maintain hygiene to prevent infections and by avoiding sick people.
  • Try to reduce physical exertion because it worsen the conditions

 

Homoeopathy managements

Homeopathy treatment being natural in nature ,treat the disease at a deeper level, to achieve the following

Control of the disease and

Symptomatic relief

Homeopathy medicine include

Alumina,

arsenic album

Carcinosin

Cadmium

Cocculus

Conium

Graphites

Gelsemium

Sepia

Sulphur

Zincum

Homoeopathy reduce the frequency of relapses and improving the power and tone of muscles.but never take homeopathic medicine without consulting a registered practitioner 



Do’s and don'ts

 

Do’s 

  • Always adopt a positive attitude and remain cheerful\
  • Take plenty of water and keep hydrated
  • Take healthy diet
  • Use eye drops and eye gels to relieve yours eyes from becoming dry.
  • Always keep some biscuits or anything to eat.
  • Be regular with your medicine and regular check up
  • Visit your doctor at regular intervals.
  • Take more rest

 

Don’ts

  • Don’t panic 
  • Avoid alcohol and smoking
  • Never try to exercise affected muscles beyond normal usage,because this lead to needless exhaustion
  • Avoid stress 
  • Don’t get too hot or cold 



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