Myasthenia Gravis is an autoimmune disease that interferes with communication between nerves and muscles. It is a chronic autoimmune disease of the neuromuscular junction, the point of contact between nerves and muscles. It is a communication problem between nerves and muscles. It results in muscle weakness. Myasthenia Gravis results from a malfunction of the immune system. The disease causes fatigue and weakening of the muscles in the affected area. There are several types of myasthenia or muscle weakness. In myasthenia gravis, the muscle weakness worsens after exertion of the affected muscles and improves with rest. The severity of myasthenia gravis comes from the risk of respiratory accidents. For unknown reasons, the body's immune system, which normally helps fight infections, attacks the acetylcholine receptors in the muscles.
In approximately 40% of patients with myasthenia gravis, the ocular muscles are the first to be affected, but in total these muscles are involved in 85% of cases during the course of the disease. In 15% of cases, only the eye muscles are affected, but in the majority of patients, all of the body's musculature can be affected.
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The Causes of Myasthenia Gravis
In myasthenia gravis, the immune system produces antibodies (proteins meant to fight foreign invaders such as bacteria, viruses or fungi) that mistakenly destroy receptor sites attached to a neurotransmitter called acetylcholine. Since there are fewer receptor sites available, the muscles receive fewer nerve signals, resulting in less muscle contraction. Nerves communicate with muscles by releasing chemicals (called neurotransmitters) that attach to receptor sites on muscle cells at the junction between the nerve and the muscle (called the neuromuscular junction).
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Antibodies can also block the function of a protein called tyrosine kinase located in muscle. This protein is involved in the formation of the neuromuscular junction. When antibodies block the function of this protein, it can lead to myasthenia gravis.
Some researchers believe that the thymus, an organ involved in the immune system and located behind the sternum, can trigger the production of antibodies that block acetylcholine. In some adults with myasthenia gravis, the thymus is abnormally large. Some people with myasthenia gravis also have thymus tumors.
Some people may have myasthenia gravis that is not caused by antibodies that block acetylcholine or tyrosine kinase. Other antibodies may play a role in the development of this condition
Symptoms of Myasthenia Gravis
Periods of worsening symptoms (exacerbations) are common. Between these episodes of exacerbation, symptoms may be minimal or even absent.
Most common symptoms of myasthenia gravis:
Weak and droopy eyelids
Breathing difficulties
Weak eye muscles, which cause double vision
Articulation and swallowing difficulties
Weak arms or legs are other common symptoms.
Neck muscles may weaken. The sensation is not altered
Lack of breath
Excessive weakness of affected muscles after straining them
Muscle weakness varies in intensity from minute to minute, hour to hour, or day to day, and the course of the disease is therefore very fluctuating. Weakness is less pronounced in cooler temperatures.
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Like Lupus, myasthenia gravis is twice as common in the female population as in the male population. However, it can appear at any age. Myasthenia gravis often affects women under 40 and men over 60. . Children are very rarely affected by this disease. The condition has the same prevalence in all continents.
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Congenital Myasthenic Syndrome
A related condition, congenital myasthenic syndrome, is passed on genetically. Myasthenia gravis probably also has a genetic component, but the children of people who have it have only a slightly higher than average chance of suffering from an autoimmune disorder.
Severity of Myasthenia Gravis
Myasthenia gravis is a serious but usually non-fatal condition. Most people with myasthenia gravis have the same life expectancy as the rest of the population. People with myasthenia gravis experience a decrease in physical activity and quality of life, and more sick days. In severe cases, the chest muscles may weaken to the point that the patient can hardly breathe on their own and may need a ventilator for some time (a few days to a few weeks)
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Symptoms and Complications
The most common symptoms of myasthenia gravis are double vision (diplopia), drooping eyelids (ptosis), and muscle fatigue, which usually worsen after exercise or at the end of the day and improve with rest.
The muscles around the eyes are particularly susceptible to myasthenia gravis, and visual disturbances are the first sign of the disease in around 40% of cases. Most people with myasthenia gravis eventually develop eye symptoms. About 15% of people will experience symptoms only around the eyes - these cases are called ocular myasthenia gravis.
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