incidence of myasthenia gravis

Written by Zhang Hui
Neurology
Updated on September 03, 2024
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Myasthenia gravis is a disease of the neurology department. Its incidence rate is around one in one hundred thousand. The prevalence rate is around fifty per one hundred thousand. In China, the incidence rate in the south is slightly higher than in the north. This is an autoimmune disease of the nervous system. Generally, it is due to the production of some abnormal antibodies. These antibodies cause dysfunction in synaptic transmission at the neuromuscular junction, leading to corresponding clinical manifestations in patients. For example, extreme fatigue after physical activity that can only be alleviated by rest. Patients may also exhibit clinical symptoms such as ptosis, diplopia, and difficulty swallowing, and in severe cases, even respiratory muscle weakness may occur, requiring the use of a ventilator. This disease can occur at any age, affecting children as well as elderly men aged 70 to 80. Therefore, correct understanding of this disease and timely treatment are very important.

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Written by Tang Bo
Neurology
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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.

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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.

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myasthenia gravis-related antibodies

Most cases of myasthenia gravis are mediated by acetylcholine receptor antibodies, involving cell-mediated immunity with complement, generally affecting the neuromuscular junction and causing a neuromuscular transmission disorder. This results in an acquired autoimmune disease of muscle weakness. However, a small number of patients with myasthenia gravis are mediated by muscle-specific kinase antibodies or low-density lipoprotein receptor-related protein 4 antibodies. Its main clinical manifestations include skeletal muscle weakness, fatigue, worsening with activity, and significant alleviation or reduction of symptoms after rest and the use of acetylcholinesterase inhibitors. Additionally, the disease can occur at any age, with females being more affected than males before the age of 40. Between 40 and 50 years old, the incidence rates between males and females are comparable, but after 50 years of age, the incidence rate in males is higher than in females.

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What is a good medicine to take for myasthenia gravis?

Myasthenia gravis is an autoimmune disease of the nervous system. Patients need to take medication for a long time, otherwise, antibodies to acetylcholine receptors might continue to be produced, further worsening the clinical manifestations. The medications taken by patients with myasthenia gravis mainly include the following types, the first being cholinesterase inhibitors. These drugs can inhibit the breakdown of acetylcholine by cholinesterase, thereby improving the transmission function between nerve and muscle junctions, and improving the clinical symptoms of patients. It is best to take these medications before meals for better absorption. The second type of medication mainly includes corticosteroids. They can suppress the body's immune response and reduce the production of antibodies, which is very helpful for the recovery from the disease. Long-term usage and gradual dosage reduction are necessary. Additionally, some immunosuppressants need to be taken. Taking these immunosuppressants also aims to suppress the immune response. However, it is essential to be aware of their adverse effects, such as suppression of bone marrow function, and damage to liver and kidney functions.

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Myasthenic crisis includes

Myasthenia Gravis, a type of immune inflammatory disease of the nervous system, is mainly caused by the production of abnormal antibodies in the body. Myasthenic crisis can endanger the life safety of patients, affecting respiratory function. There are mainly three types of crises: The first type of crisis is the myasthenic crisis, which is also the most common. Generally, it is caused by the progression of the disease itself, often due to insufficient anticholinesterase drug dosage. The second type of crisis is the cholinergic crisis, caused by an overdose of anticholinesterase drugs, resulting in symptoms like muscle tremors in patients. The third type is the paradoxical crisis, which occurs due to insensitivity to anticholinesterase drugs, leading to severe respiratory difficulties. It is essential to handle a myasthenic crisis promptly, maintain the patient's airway clearance, and use a ventilator for treatment if necessary.