What medicine should be taken for myasthenia gravis?

Written by Zhang Hui
Neurology
Updated on March 12, 2025
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Myasthenia gravis is a type of neurological immunological disease in neurology, mainly caused by a disorder of the body's own immune function. Patients in the body will produce antibodies against acetylcholine receptors, thus affecting the transmission of nerve impulses at the neuromuscular junction. For this disease, the following medications are generally prescribed: The first type of medication is a cholinesterase inhibitor, which can increase the amount of acetylcholine at the neuromuscular junction, thereby effectively improving clinical symptoms. The second type of medication is corticosteroids, because this disease is caused by an abnormal inflammatory response. Therefore, taking corticosteroids can suppress the inflammatory response. Treatment generally starts with a small dose and gradually increases, maintaining for a period before gradually tapering off. It may also be necessary to take other immunosuppressants. (Please take the medication under the guidance of a doctor)

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Written by Zhang Hui
Neurology
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How to treat myasthenia gravis?

Myasthenia gravis falls under the category of neurological diseases, characterized as an immune disorder of the nervous system, primarily due to the presence of antibodies against acetylcholine receptors. This leads to impaired transmission of nerve impulses to muscles, resulting in various clinical symptoms. The treatment approaches for myasthenia gravis include the following. Firstly, the use of cholinesterase inhibitors is recommended. These medications increase acetylcholine levels and are effective in improving symptoms. Secondly, patients are treated with corticosteroids, typically starting with a low dose and gradually increasing to maintain for a period before reducing the dose again. Adjustments to medication should always be made under the guidance of a neurologist. Third, if the patient has a thymoma, surgical removal is advised.

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Written by Liu Yan Hao
Neurology
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Does myasthenia gravis hurt?

Myasthenia gravis does not cause pain. Initially, patients with myasthenia gravis may feel discomfort such as soreness or swelling in the eyes or limbs, blurred vision, or fatigue. As the condition progresses, skeletal muscles become noticeably fatigued and weak. A significant characteristic is muscle weakness, which worsens after exertion in the afternoon or evening and improves after rest in the morning, known as "morning better, evening worse." Patients with myasthenia gravis can experience involvement of skeletal muscles throughout the body, manifesting as drooping eyelids, blurred vision, double vision, strabismus, restricted eye movements, bland facial expressions, a "forced smile" appearance, speech impairments resembling a thick tongue often accompanied by a nasal sound. Additionally, they may have chewing difficulties, coughing or choking when drinking, swallowing difficulties, trouble raising the head, weak shoulder shrugging, difficulty lifting arms, combing hair, climbing stairs, squatting, and getting into vehicles, primarily due to muscle weakness, which does not lead to pain.

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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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Written by Tang Bo
Neurology
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Myasthenia Gravis Clinical Manifestations

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 Liu Hong Mei
Neurology
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Can myasthenia gravis use non-invasive ventilators?

Myasthenia gravis can be treated with a non-invasive ventilator, and it is generally manageable with medication. Early stages of myasthenia gravis may present with symptoms such as ptosis, poor breathability, respiratory difficulty, worsening symptoms after activity, and increased severity in the evening. Respiratory weakness might require treatment with a non-invasive ventilator. If respiratory weakness does not improve with medication and leads to respiratory failure, it is advisable to use a non-invasive ventilator to improve the patient's symptoms and alleviate difficulties. Respiratory muscle weakness can be life-threatening and requires active treatment.