Causes of myasthenia gravis

Written by Zhang Hui
Neurology
Updated on February 24, 2025
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Myasthenia gravis is a type of neurological autoimmune disease. The cause and mechanism of this disease are primarily due to disorders in the immune function of the body. Antibodies are produced in the body which attack the acetylcholine receptors at the neuromuscular junction, leading to the failure of nerve impulses being transmitted to the muscles. This results in the clinical symptoms observed. Many patients may have thymic abnormalities, such as thymomas. Treatment of this disease involves the use of cholinesterase inhibitors and suppression of these abnormal immune responses, typically requiring the use of corticosteroids.

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Written by Zhang Hui
Neurology
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incidence of myasthenia gravis

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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Written by Zhang Hui
Neurology
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What should I do if myasthenia gravis is accompanied by a fever?

Patients with myasthenia gravis are most afraid of developing a fever, as a fever may indicate an infection, especially a bacterial infection. If a bacterial infection occurs, it can easily trigger a myasthenic crisis. The patient may experience weakness in breathing and even respiratory failure, which can be life-threatening. Therefore, it is essential to address the situation promptly. The recommended approach when a fever occurs is as follows: First, quickly determine the cause of the fever, complete routine blood tests, calcitonin, and other relevant assays to confirm if it is caused by a bacterial infection. Second, symptomatically manage the fever, possibly using antipyretic medications. Third, if it is a bacterial infection, it is crucial to promptly administer a significant amount of effective antibiotics to treat it. Controlling the bacterial infection can prevent the progression of myasthenia gravis to a more severe state. (Note: Medication should be used under the guidance of a doctor.)

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Written by Zhang Hui
Neurology
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The difference between amyotrophic lateral sclerosis and myasthenia gravis

These two are distinctly different diseases. Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, which is a degenerative neurological condition primarily affecting the upper and lower motor neurons. Patients may exhibit symptoms such as muscle atrophy, muscle twitching, general weakness, as well as potential difficulties in swallowing, articulation disorders, and atrophy of the tongue muscles. The mechanism of this disease is not very clear, symptoms progressively worsen, and there are no effective treatment methods. Neurogenic changes can be observed in electromyography. Myasthenia gravis, on the other hand, is a typical neuromuscular junction disease caused by immune dysfunction. It presents with skeletal muscle fatigue and weakness, typically worsening in the evening. Treatment with immunosuppressants has been shown to be effective.

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Written by Shi De Quan
Neurology
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What should I do if myasthenia gravis causes difficulty swallowing?

Myasthenia gravis primarily manifests as an inability to swallow, affecting the pharyngeal muscles or the muscles involved in swallowing. Thus, difficulty in swallowing is also a symptom of myasthenia gravis. At this time, the main treatment should focus on the primary disease, administering medications such as neostigmine for myasthenia gravis, and using steroids or immunosuppressants in severe cases. If there is difficulty in swallowing, or if it persists for more than two or three days, a gastric tube can be inserted for nasal feeding to maintain nutrition. Then, as the symptoms of myasthenia gravis subside with medication, swallowing function can recover.