What is myasthenia gravis?

Written by Zhang Hui
Neurology
Updated on September 16, 2024
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Myasthenia gravis is a group of neuromuscular junction disorders and is also an autoimmune disease of the nervous system. It primarily involves the production of certain antibodies in the body that attack the acetylcholine receptors on the postsynaptic membrane of the neuromuscular junction. This results in the inability of nerve impulses to be effectively transmitted to the muscles, causing the muscles to lose neural control, leading to weakness of the limbs. This weakness is typically more pronounced in the evening than in the morning, with symptoms being lighter upon waking and worsening in the afternoon. As the disease is caused by an autoimmune response, a major focus of treatment is to suppress this abnormal immune reaction, primarily through the administration of corticosteroids. Additionally, many patients with myasthenia gravis also exhibit thymus abnormalities, necessitating thorough CT examinations of the thymus.

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Can metronidazole be used for myasthenia gravis?

Patients with myasthenia gravis must use ornidazole with caution and under the guidance of a doctor because the side effects of ornidazole may exacerbate myasthenia gravis. However, ornidazole is not relatively or absolutely contraindicated for patients with myasthenia gravis. Generally, the patient's side effects are observed, and if myasthenia gravis is aggravated, the use of ornidazole is recommended to be cautious or prohibited. Ornidazole can cause neurological reactions, including headache, fatigue, dizziness, trembling, limb numbness and weakness, convulsions, mental confusion, epileptic seizures, ataxia, and consciousness disturbances, and may cause peripheral nerve damage.

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Can myasthenia gravis with eyelid drooping be cured?

Myasthenia gravis with ptosis is treatable. The ptosis is a manifestation of myasthenia gravis, which is generally mild. This type of myasthenia gravis is usually treatable with Pyridostigmine. If oral medication is ineffective, using steroids or immunosuppressants can also lead to recovery. This is typically a mild form of myasthenia gravis, so oral medication generally leads to a cure.

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Can severe myasthenia gravis be cured by massage?

Myasthenia Gravis cannot be treated through massage, as it is an acquired autoimmune disease primarily caused by damage to the acetylcholine receptors at the neuromuscular junction. Treatment involves the use of immunosuppressive medications such as corticosteroids, immunosuppressants, and azathioprine. Typically, high doses of corticosteroids are administered to suppress the immune-inflammatory response and reduce the production of acetylcholine receptor antibodies, allowing a sufficient number of acetylcholine receptors to be preserved. Additionally, acetylcholinesterase inhibitors can be used to decrease the breakdown of acetylcholine and increase its concentration in the synaptic gap, thus promoting impulse transmission at the neuromuscular junction and improving symptoms of muscle weakness. The most commonly used medications in standard treatment include pyridostigmine, and corticosteroids such as methylprednisolone or prednisolone. (Please use medications under the guidance of a doctor)

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Types of myasthenia gravis crisis

Myasthenic crises are categorized into three types, all resulting from worsening conditions or improper treatment, leading to respiratory muscle weakness or paralysis and subsequent difficulty in breathing. The first type occurs due to various triggers or reduction in medication, or after the application of acetylcholinesterase inhibitors which temporarily alleviate the crisis, known as the cholinergic crisis. The second type is a result of excessive use of acetylcholinesterase inhibitors during a cholinergic crisis. Beyond respiratory difficulties, symptoms may also include signs of toxicity such as vomiting, abdominal pain, diarrhea, pupil constriction, excessive sweating, drooling, increased tracheal secretions, and potential muscle tremors, spasms, as well as anxiety, insomnia, confusion, seizures, and coma. The third type is the paradoxical crisis, where neither ceasing nor increasing medication doses alleviates the symptoms, typically occurring after long-term, high-dose medication use.

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Myasthenia gravis initial symptoms

Myasthenia gravis is characterized by fluctuating and fatigue-prone muscle weakness in certain specific striated muscles. Symptoms are generally milder in the morning and more severe in the evening, worsening with continued activity and alleviating after rest. The most common initial symptom is weakness of the external eye muscles, primarily presenting as asymmetrical ptosis (drooping of the upper eyelid) or narrowing of the eye slit, along with diplopia, which refers to seeing double images. These are the most frequent initial symptoms, seen in over 50% of patients with myasthenia gravis. Additionally, some patients may experience disturbances in eye movement, facial muscle weakness, air leakage when puffing cheeks, incomplete eyelid closure, shallower nasolabial folds, as well as difficulty swallowing, speech articulation issues, choking while drinking, and potentially severe respiratory weakness.