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Myasthenia gravis

  • Alternative Names

    Neuromusclar disorder - myasthenia gravis


    Treatment

    There is no known cure for myasthenia gravis. However, treatment may result in prolonged periods without any symptoms (remission).

    Lifestyle adjustments usually enables continuation of many activities. Activity should be planned to allow scheduled rest periods. An eye patch may be recommended if double vision is bothersome. Stress and excessive heat exposure should be avoided because they can worsen symptoms.

    Some medications, such as neostigmine or pyridostigmine, improve the communication between the nerve and the muscle. Prednisone and other medications (such as azathioprine, cyclosporine, or mycophenolate mofetil) that suppress the autoimmune response responsible for the weakness may be used if symptoms are severe and other medications don't work well enough.

    Plasmapheresis may reduce symptoms for 4 - 6 weeks and is often used before surgery. In this technique, the person's blood plasma (the clear part of the blood) containing the antibodies is removed from the body and replaced with donated, antibody-free plasma or with other intravenous fluids.

    Intravenous immunoglobulin infusions may be as effective as plasmapheresis. In this technique, a large volume of a mixture of helpful antibodies is given directly into the bloodstream to blunt the effect of the autoimmune antibodies.

    Surgical removal of the thymus (thymectomy) may result in permanent remission or less need for medicines, especially when there is a tumor present.

    Patients with eye problems may try lens prisms to improve vision. Surgery may also be performed on the eye muscles.

    Several medications may make symptoms worse and should be avoided. Therefore, it is always important to check with your doctor about the safety of a medication before taking it.

    Crisis situations, where muscle weakness involves the breathing muscles, may occur without warning with under- or overuse of medications. These attacks seldom last longer than a few weeks. Hospitalization and assistance with breathing may be required during these attacks. Often plasmapheresis is used to help end the crisis.


    Support Groups

    The stress of illness can often be helped by joining support groups where members share common experiences and problems. See myasthenia gravis - support group.


    Expectations (prognosis)

    There is no cure, but long-term remission is possible. There may be minimal restriction on activity in many cases. People who have only eye symptoms (ocular myasthenia gravis), may develop generalized myasthenia over time.

    Pregnancy is possible for a woman with myasthenia gravis but should be closely supervised. The baby may be temporarily weak and require medications for a few weeks after birth but usually does not develop the disorder.


    Complications
    • Complications of surgery
    • Myasthenic crisis (breathing difficulty), may be life threatening
    • Restrictions on lifestyle (possible)
    • Side effects of medications (see the specific medication)

    Calling your health care provider

    Call your health care provider if you develop symptoms of myasthenia gravis.

    Go to the emergency room or call the local emergency number (such as 911) if you have breathing difficulty or swallowing problems.