Today, there are many autoimmune diseases. Some can be eliminated with the right therapy, while others are not amenable to treatment, and the only thing medicine can do is prevent flare-ups.
In the article we will talk about such a pathology as myasthenia gravis: symptoms, diagnosis, treatment of the disease - we will try to discuss all these points in as much detail as possible. In addition, we will find out who is most susceptible to illness, whether there are ways to avoid such a nuisance.
What is myasthenia gravis?
Myasthenia gravis is an autoimmune disease that causes progressive muscle weakness. This happens as a result of failures in the neuromuscular transmission. In most cases, the muscles of the eyes, chewing and facial, are affected, less often - performing the respiratory function.
According to statistics, myasthenia gravis more often affects older women, although recently it has begun to register among the younger generation.
Disease classification
Almost every disease can be classified by type. Myasthenia gravis was no exception. The form of the disease may depend on various factors, so consider the most common types.
Depending on the age category of the patient, myasthenia can be:
- congenital;
- newborns;
- youthful;
- adults;
- late version.
Depending on the clinical signs, the following types of disease called myasthenia gravis are distinguished:
- eye form;
- musculoskeletal;
- pharynofacial;
- generalized.
The symptoms of each type of ailment will be considered below.
Causes of disease development
The root cause of the development of the disease still remains unexplored. It is only known that the disease occurs due to the blocking of receptors in the muscles by the immune system. As a result, they are unable to respond to the nerve signals they receive.
Myasthenia gravis can be congenital or acquired. The first form is much less common and is caused by gene mutations.
Acquired myasthenia gravis can manifest itself against the background of thymomegaly (benign thymus hyperplasia) or tumors. Less often, the cause of the disease can be autoimmune pathologies, for example, scleroderma or dermatomyositis.
There are many cases when myasthenia gravis developed against the background of oncological diseases. In particular, thisconcerns tumors of the genital organs (prostate, ovaries), less often - the liver, lungs, and so on.
Symptoms of disease
Which signs would allow a diagnosis of myasthenia gravis? Symptoms may differ or combine depending on the form of the disease and its stage.
Myasthenia gravis affects:
- circular muscle of the eye;
- oculomotor muscle;
- the muscle responsible for lifting the upper eyelid.
As a result, the symptoms of this form of the disease may be as follows:
- difficulty in focusing;
- strabismus;
- double vision;
- inability to look at distant or too close objects for a long time;
- drooping of the upper eyelid (ptosis).
The last of the considered signs can manifest itself only in the late afternoon, and be completely absent in the morning.
The facial form of myasthenia gravis is accompanied by the following symptoms:
- changing voice that becomes "nasal" and deaf;
- difficulties with speech (the patient gets tired even after a few minutes of talking);
- difficulty eating (very difficult for patient to chew solid food due to muscle weakness).
When the pharynx is affected, there is a high probability of water entering the respiratory tract. This is due to the fact that the patient is not able to take liquid food and may choke, which happens quite often. As a result, this is fraught with the development of aspiration pneumonia.
Musculoskelet althe form of the disease is accompanied by increased fatigue of a particular part of the body. In most cases, this applies to the limbs. There were cases when the patient could not even take a regular cup of water or climb stairs.
The most dangerous is the generalized form of the disease. It is manifested by weakness of the respiratory muscles, which can lead to the development of acute hypoxia and death.
As you can see, myasthenia gravis, the symptoms of which are quite diverse, is a very serious and life-threatening pathology. That is why it is important to notice the appearance of a problem in a timely manner and take all necessary measures.
Therefore, the following points that we will consider under the topic "Myasthenia Gravis" are the diagnosis and treatment of the disease.
Diagnostics
Myasthenia gravis is a rather rare disease. Therefore, a neurologist cannot always make a correct diagnosis quickly.
What should a doctor do to detect a disease such as myasthenia gravis? Diagnosis may include:
- questioning the patient for complaints;
- clinical examination;
- proserin test;
- testing with edrophonium;
- electromyographic study;
- determination of the level of antibodies to acetylcholine receptors in blood serum;
- ophthalmic examination;
- chest computed tomography;
- MRI;
- lung function test.
During the study, it is important to exclude all possible diseases, the symptoms of which are to some extent similar to the manifestations of myasthenia gravis. For example, it can be bulbar syndrome, inflammatory diseases (meningitis, encephalitis), tumor formations in the brain stem (hemangioblastoma, glioma), neuromuscular pathologies (myopathy, Guillain's syndrome, ALS and others), cerebrovascular accidents (ischemic stroke) and so on.
Medicated treatment of myasthenia gravis
Depending on the symptoms and the stage of development of the disease, the type of therapy required may also differ.
First of all, it is necessary to take drugs that improve the transmission of impulses in the neuromuscular junctions. Most often, for these purposes, such pharmacological agents as Oksazil, Prozerin, Pyridostigmine, and so on are used. All of them have a similar type of action and increase the concentration of acetylcholine. These drugs are quite effective in getting rid of the pathology in the early stages of its development, as well as during the onset of crises.
The next thing to do is to properly adjust the water and electrolyte balance in the body. This will require a sufficient supply of B vitamins and a normal potassium metabolism.
The progression of the disease requires the adoption of more aggressive measures of therapy. They are taking immunosuppressive hormones. Despite the fact that suchdrugs are difficult to tolerate by the body, the benefits of their use are much more significant than possible side effects, especially when it comes to preserving not only he alth, but also life.
Pay attention
There are some drugs that are strictly forbidden to take when diagnosed with myasthenia gravis. These include beta-blockers, magnesium s alts, calcium antagonists, aminoglycoside antibiotics, thyroid hormones, tranquilizers, morphine, quinine derivatives, antipsychotics, barbiturates, and most hypnotics and sedatives.
In addition, we must not forget that any pharmaceutical preparation can be taken only after a doctor's prescription, taking into account all the individual characteristics of the body.
Treatment with surgery
Drug therapy is not always able to bring the desired result and get rid of the problem. Therefore, there is often a need for surgical intervention. It, in turn, may include one or more procedures:
- mechanical ventilation of the lungs when spontaneous breathing is impossible;
- plasmapheresis to clean the blood of abnormal antibodies, while the process itself must be carried out regularly at regular intervals;
- occupational therapy and physiotherapy - these two procedures will not get rid of the disease, but will help the patient cope with fluctuations in muscle strength.
In addition, it may be necessary toremoval of the thymus gland through surgery.
Stem cell treatment
This type of getting rid of the problem has not yet become widespread, but it is still worth remembering about it.
Treatment with stem cells derived from adipose tissue has shown a fairly high efficiency in the fight against the disease. They contribute to the maximum extension of the remission period. He althy stem cells help restore breathing and swallowing processes. In addition, they contribute to the elimination of ptosis in the shortest possible time.
The course of treatment and the frequency of introducing stem cells into the body can only be prescribed by an experienced specialist!
Forecast for the future
Even in the last century, the diagnosis of "Myasthenia" meant an inevitable death. But time passes, and medicine does not stand still. At the moment, many special drugs have been developed that help save lives and maximize the period of remission.
At the same time, we must not forget that myasthenia gravis is a chronic disease. And this means that patients will have to be on treatment all the time (permanent or courses) to maintain their he alth. It is easy to guess that the quality of life in this case can be noticeably affected.
Therefore, it is worth repeating once again that only timely diagnosis of the disease can promptly stop its progression and avoid complications.
Relapse Prevention
We talked about such a pathology as myasthenia gravis. What it is, what symptoms accompany the disease, and whether there is an effective treatment for the disease were also discussed. Finally, I would like to dwell on ways to prevent relapses, since this topic is very relevant for patients.
Firstly, registration with a neurologist is important. In this case, in no case should you miss scheduled appointments, and if symptoms of the disease occur, you should contact the doctor immediately, without waiting for the next visit.
Secondly, you need to review and, if necessary, correct your habitual lifestyle. In no case should patients with myasthenia be allowed to be physically overworked, therefore it is advisable to choose a job that involves mental work. If possible, limit long trips, especially public transport.
We must not forget that any disease, even SARS, causes stress in the body and malfunctions in the immune system. Therefore, it is important to carefully monitor your he alth, avoid hypothermia and not be in crowded places during a period of widespread infectious diseases.
If you have myasthenia gravis, taking any medication should be agreed with your doctor, as there are many special contraindications (some of which were mentioned above).
Don't self-medicate and stay he althy!
