MYASTHENIA GRAVIS

 MYASTHENIA GRAVIS

Myasthenia grace is a rare disease, with a prevalence of 5 per 100000. It is a disorder of neuromuscular transmission. Females are more prone with this disorder than males.
 This is characterised by 
> weakness and fatigue in some or all muscle groups
>  weakness worsening on repeated exertion or towards the end of the day, and relived by rest 
This condition is a consequence of an auto immune destruction. 
It occurs when communication between nerve cells and muscles impaired. The most commonly affected muscles of eyes , face, swallowing and also muscles responsible for breathing and even arms and legs. 

Symptoms: 
1. Weakness of eye opening and eye closing
2. Weakness of neck muscles and results in lolling of the head 
3. Fatigue by movement against any resistance 
4. Muscles wasting 
5. Difficulty in swallowing 
6. Difficulty in speech 
7. Weakness of jaw muscles allows the mouth to hang open 
8. Double vision 
9. Change in face expression 
10. Shortness of breath 
11. Weakness in arm and leg muscles 
12. Problems with chewing

 Causes : 
> In Thymus gland dysfunction 
> Genetic factors also may be associated with this disorder 
> When communication between nerve cells and muscles impaired 
> A reduction of Acetylcholine receptor sites in post synaptic folds. Reduced receptor synthesis and increased receptor destruction, and also the blocking of receptor response to acetylcholine, all are responsible for the disorder. 


TREATMENT: 
1. Anticholinesterase drugs : inhibit cholinesterase , the enzyme responsible for the break down of acetylcholine allowing enhanced receptor stimulation. So that more acetylcholine is available to effect neuromuscular transmission. 
2. Steroids 
3. Immunosuppressants for patients who do not respond to steroids 
4. Plasmapheresis 
5. Speech therapy 
6. Occupational therapy 
7. Physiotherapy : Low impact exercises like swimming, slow jogging, slow walking may actually reduce fatigue. Because inactivity may increase obesity and chances of coronary heart disease, osteoporosis. 
8. Surgery : when Thymoma is present
9. Blood transfusion to replace deficiencies in the blood stream 
10. Muscle strengther for better muscle function

Note: Please consult your doctor before starting any exercise program