Myasthenia Gravis Clinical Manifestations

Written by Tang Bo
Neurology
Updated on September 01, 2024
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The clinical manifestations of myasthenia gravis include fluctuating weakness of specific striated muscles that is fatigue-prone. Symptoms are generally milder in the morning and worsen by night, increasing after sustained activity and alleviating after rest. Additionally, some patients may experience ocular muscle weakness, presenting with ptosis and diplopia, which could be among the earliest symptoms. Eye movement disorders may occur, preventing the eyes from looking to one side, and pupil abnormalities may be present. Facial muscle weakness can lead to cheek puffing and air leakage, inability to close the eyes, or asymmetry of the mouth, resembling a forced smile. There may also be weakness in the masticatory muscles, leading to difficulties in chewing and swallowing, potential speech impairments, and coughing when drinking water. Neck muscle weakness may manifest as difficulty in lifting the head. Muscle weakness can affect various limbs, primarily proximally, and respiratory muscle weakness can lead to breathing difficulties and dryness.

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Written by Zhang Hui
Neurology
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What is myasthenia gravis?

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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Written by Liu Hong Mei
Neurology
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Can people with myasthenia gravis soak their feet?

Soaking in hot water can promote blood circulation, dilate blood vessels, improve local blood circulation in the lower limbs, promote metabolism, prevent thrombosis, and prevent muscle atrophy. In the early stages of myasthenia gravis, patients often experience limb discomfort, numbness, pain, blurred vision, and fatigue. In work and daily life, it is common to experience tiredness, memory loss, slow responses, and reluctance to be active. Soaking the feet can promote blood circulation and can improve local blood flow, which has a certain beneficial effect on myasthenia gravis. As the disease progresses, there is obvious fatigue and weakness in the skeletal muscles, especially after fatigue in the afternoon and evening, which is reduced in the morning or after rest.

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Written by Shi De Quan
Neurology
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Can myasthenia gravis affecting respiration be cured?

Myasthenia gravis affecting respiration can be cured because myasthenia gravis can improve after treatments such as oral medication or plasmapheresis. Another possibility is myasthenia gravis concurrent with a myasthenic crisis, which has various forms, causing respiratory difficulties. At this point, symptomatic treatment is required, including the use of ventilators, intubation, and in severe cases, a tracheotomy. After the critical period on the ventilator passes, respiratory function can improve or the myasthenia can ameliorate.

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Written by Zhang Hui
Neurology
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Does myasthenia gravis cause sensitivity to cold?

Patients with myasthenia gravis tend to be sensitive to cold, mainly due to the following factors: Firstly, patients with myasthenia gravis generally experience overall weakness and have very limited physical activity, making their physique rather frail. Patients with a weak physique are definitely more susceptible to colder environments. Secondly, patients with myasthenia gravis have lower resistance to diseases and often take immunosuppressants for a long time, making them highly susceptible to respiratory and lung infections. In cold conditions, some viruses can exploit this weakness, leading to exacerbated lung and respiratory infections, which is another major reason why patients with myasthenia gravis are sensitive to cold. Thirdly, myasthenia gravis is an autoimmune disease that leads to immune dysfunction. This immune dysfunction makes patients particularly sensitive to cold stimuli. In a cold environment, their immune function may become even more disordered, contributing further to their sensitivity to cold.

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Written by Zhang Hui
Neurology
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Can people with myasthenia gravis smoke?

Patients with myasthenia gravis are advised not to smoke. It is best to avoid smoking because myasthenia gravis is a disease caused by an autoimmune disorder, and smoking can further damage the body's immune function, leading to an exacerbation of the disease. Additionally, patients with myasthenia gravis may experience disturbances in respiratory function, leading to insufficient breathing and are highly susceptible to complications like lung infections. They are particularly at risk of respiratory infections, which can trigger a myasthenia gravis crisis, and in severe cases, can endanger the patient's life. It is well known that smoking has a very negative impact on the lungs and respiratory tract, easily damaging bronchial cells and inducing bronchial infections. Therefore, smoking-induced infections can cause acute exacerbation in patients with myasthenia gravis, and in severe cases, even threaten the patient's life safety.