Myasthenia Gravis Surgical Treatment

Written by Xie Wen
Neurology
Updated on March 20, 2025
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Myasthenia gravis is an autoimmune disease, with many patients also having a thymoma. The thymus is a very important immune organ in humans, and abnormal proliferation of the thymus can produce acetylcholine receptor antibodies. These antibodies circulate to the neuromuscular junction and participate in the antigen-antibody reaction, leading to the onset of myasthenia gravis. By removing the thymus, the initiating antigens of the patient's autoimmune response can be eliminated, reducing the involvement of T cells, B cells, and cytokines in the autoimmune response. This surgery is suitable for patients with thymic hyperplasia and high acetylcholine receptor antibody titers, or those with various types of myasthenia gravis with thymoma, as well as young women with generalized myasthenia gravis, and those who are dissatisfied with cholinesterase inhibitor treatment. About 70% of patients can experience symptom relief or complete recovery after surgery.

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What should not be eaten in the case of myasthenia gravis?

Myasthenia gravis is an autoimmune disease of the nervous system, primarily due to dysfunction at the neuromuscular junction, leading to skeletal muscle fatigue. Symptoms include drooping eyelids, double vision, overall weakness, and even swallowing difficulties. Foods that should be avoided in myasthenia gravis mainly include certain medications, such as aminoglycoside antibiotics, which should not be taken orally by patients, as well as fluoroquinolone antibiotics. These antibiotics can exacerbate neuromuscular transmission disorders, potentially worsening the disease. Additionally, benzodiazepines, barbiturates, and some anti-arrhythmic drugs can also reduce muscle membrane excitability and should be avoided.

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Myasthenia Gravis should be seen by which department?

Myasthenia gravis is considered a neurological disease, so if myasthenia gravis is suspected, it is advisable to consult a neurologist. Neurologists are quite familiar with myasthenia gravis, especially those who specialize in its research. They are particularly knowledgeable about diagnosing and treating this disease. Myasthenia gravis is an autoimmune disease of the nervous system that primarily affects the neuromuscular junction, causing muscle weakness in the body. The symptoms typically worsen towards the evening and include pathological fatigue. Muscle weakness usually improves after rest. Clinical manifestations also include ptosis, double vision, difficulty swallowing, and coughing while drinking. Neurologists may prescribe various diagnostic tests such as electromyography, chest CT scans, and tests for acetylcholine receptor antibodies.

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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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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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Early symptoms of myasthenia gravis

Myasthenia gravis is a disease of the neuromuscular junction and also an autoimmune disease, caused by a dysfunction in the patient's immune system. Early symptoms of myasthenia gravis may include mild general fatigue, which can be relieved by rest, and may not be particularly concerning to the individual. Some patients may initially exhibit slight ptosis and occasional double vision as clinical symptoms, which they might not take very seriously either. As the disease progresses, the symptoms become more severe, such as noticeable ptosis, double vision, slurred speech, difficulty swallowing, and even potential weakness of the respiratory muscles, leading to respiratory failure.