The myasthenia gravis or myasthenia gravis, is an autoimmune disease that causes progressive muscle weakness, more common in women and usually begins between 20 and 40 years of age. The symptoms of myasthenia gravis may begin suddenly, but usually are appearing and worsening gradually.
The causes of myasthenia gravis are related to a change in the immune system that causes antibodies to attack certain fundamental structural for the control of the muscles.
The myasthenia gravis do not have a definitive cure but the treatment adapted for each case with specific remedies and physical therapy exercises can improve the quality of life.
The initial symptoms the most common of myasthenia gravis are:
- Weakness of the eyelid and difficulty opening the eyes, or blinking;
- Weakness of the muscles of the eyes, which leads to strabismus and double vision;
- Muscle fatigue excessive after exercise or physical exertion.
With the advance of the disease, the symptoms worsen and include:
- Weakness of the muscles of the neck leaving the head curved to the front or to the side;
- Difficulty climbing stairs, lifting arms, to write;
- Difficulty to speak and to swallow the food;
- Weakness of the arms and of the legs, which varies in intensity over hours or days.
In the episodes more severe, there may also be involvement of respiratory muscles, a condition called crisis miastênica, which is serious and can lead to death if not treated quickly in the hospital.
Typically, the symptoms worsen with repetitive use of the muscle affected, but it can also happens when it is exposed to heat, when it is under stress or anxiety, or when using remedies anxiolytics or antibiotics.
How is it treated
Most of the times the doctor suspects the diagnosis of myasthenia gravis through the assessment of symptoms, physical examination, and the study of the health history of the person.
However, several tests can be used to mislead other problems and to confirm myasthenia gravis. Some of these tests include electromyography, magnetic resonance, computed tomography, and blood tests.
What causes myasthenia gravis
The myasthenia gravis is caused by a change in the immune system that leads some antibodies attack the receptors present in the muscles. When this happens, the electrical cannot pass properly from the neurons to the muscle fibers and, therefore, the muscles do not contract, demonstrating the weakness characteristic of myasthenia.
How is it treated
There are several types of treatment that can improve the quality of life of the person, depending on the symptoms presented. Some of the most used ways include:
The remedies are the form of treatment most widely used, because, in addition to practical, have excellent results. The types of medications most commonly used are:
- Cholinesterase inhibitors, such as Pyridostigmine: improve the passage of the electrical stimulus, between the neuron and the muscle, improving contraction and muscle strength;
- Corticoids, such as Prednisone: decreases the effect of the immune system and, therefore, can reduce various kinds of symptoms. However, may not be used for a long time, since they can have various side effects;
- Immunosuppressants, such as Azathioprine or Cyclosporine: these drugs also decrease the functioning of the immune system, but are used in more severe cases, when the symptoms do not improve with other remedies.
In addition to the remedies oral the doctor can also indicate the use of intravenous medication, such as monoclonal antibodies, that decrease the amount of some defense cells in the body, improving the symptoms of myasthenia gravis.
Plasmapheresis has is a therapy, similar to dialysis, in which blood is withdrawn from the body and passed through a machine that removes excess antibodies that attack the muscle receptors, thereby facilitating the passage of the electrical signal between the neurons and the muscle fibers.
Although it is a treatment with good results, it also has some health risks such as bleeding, muscle spasms, and even severe allergic reactions.
Surgery is a treatment which is rare, but can be necessary when it is identified a tumor in some organ of the immune system that is causing the production of antibodies that cause the myasthenia gravis.
Physiotherapy motor and respiratory are also indicated in the treatment of myasthenia gravis with the goal to strengthen the muscles, improve the range of the movements, the breathing and prevent respiratory infections.