Today, there are many autoimmune diseases. Some can be eliminated with the help of properly selected therapy, while others cannot be treated, and the only thing that medicine can do is to prevent exacerbations.
In the article, we will talk about such a pathology as myasthenia gravis: symptoms, diagnosis, treatment of the disease - we will try to discuss all these points in more detail. In addition, we find out who is most susceptible to the disease, are there ways to avoid such a nuisance.
What is myasthenia gravis?
Myasthenia gravis is an autoimmune disease that causes progressive muscle weakness. This happens as a result of failures in the neuromuscular transmission. In most cases, the muscles of the eyes, chewing and facial, suffer less often, performing respiratory function.
According to statistics, myasthenia gravis often affects women aged, although recently it has begun to be recorded among the younger generation.
Disease classification
Almost every disease can be classified by type. Myasthenia gravis was no exception. The form of the disease may depend on various factors, so consider the most common types.
Depending on the age category of the patient, myasthenia gravis may be:
- congenital;
- newborns;
- youthful;
- Adults
- late option.
Depending on the clinical signs, the following types of disease are distinguished under the name myasthenia gravis:
- ocular form;
- musculoskeletal;
- pharyngeal-facial;
- generalized.
The symptoms of each of the types of ailment are discussed below.
Causes of the disease
The root cause of the development of the disease is still unexplored. It is only known that the disease arises due to the blocking of the receptors in the muscles by the immune system. As a result, they are not able to respond to received nerve signals.
Myasthenia gravis disease can be congenital or acquired. The first form is much less common, and the cause of its occurrence is gene mutations.
Acquired myasthenia gravis can manifest itself against the background of thymomegaly (benign thymus hyperplasia) or tumors. Autoimmune pathologies, for example, scleroderma or dermatomyositis, can become the cause of the disease less often.
There are many cases when myasthenia gravis developed against the background of cancer. In particular, this applies to tumors of the genital organs (prostate gland, ovaries), less often - the liver, lungs and so on.
Symptoms of the disease
What signs will make it possible to diagnose myasthenia gravis? Symptoms may differ or combine depending on the form of the disease and its stage.
Ocular myasthenia gravis affects:
- circular muscle of the eye;
- oculomotor muscle;
- the muscle that is responsible for raising the upper eyelid.
As a result, the symptoms of this form of the disease can be as follows:
- difficulty focusing your eyes;
- strabismus;
- double vision
- the inability for a long time to look at distant or too close objects;
- prolapse of the upper eyelid (ptosis).
The last of the considered signs can manifest itself only in the late afternoon, and completely absent in the morning.
The facial form of myasthenia gravis is accompanied by the following symptoms:
- a change in voice that becomes nasal and deaf;
- difficulties with speech (the patient gets tired even after a few minutes of conversation);
- difficulty in eating (the patient is very difficult to chew solid food due to weakness of the corresponding muscles).
If the throat is affected, there is a high probability of water entering the respiratory tract. This is due to the fact that the patient is not able to take liquid food and can choke, which happens quite often. As a result, this is fraught with the development of aspiration pneumonia.
The musculoskeletal form of the disease is accompanied by increased fatigue of a particular part of the body. In most cases, this applies to the limbs. There have been cases when the patient could not even take an ordinary cup of water or climb the stairs.
The most dangerous is a generalized form of the disease. It is manifested by weakness of the respiratory muscles, which can lead to the development of acute hypoxia and death.
As you can see, myasthenia gravis, whose symptoms are quite diverse, is a very serious and life-threatening pathology. That is why it is important to notice the occurrence of a problem in a timely manner and take all necessary measures.
Therefore, the following points that we will consider under the theme "Myasthenia Gravis" are the diagnosis and treatment of the disease.
Diagnostics
Myasthenia gravis is a fairly rare disease. Therefore, a neurologist can not always quickly make the correct diagnosis.
What does a doctor need to do to detect a disease such as myasthenia gravis? Diagnostics may include:
- interrogation of the patient for complaints;
- clinical examination;
- conducting a proserin test;
- test with edrophony;
- electromyographic study;
- determination of the level of antibodies to acetylcholine receptors in the blood serum;
- ophthalmologic examination;
- chest computed tomography;
- MRI
- checking lung function.
During the study, it is important to exclude all possible diseases, the symptoms of which are to some extent similar to the manifestations of myasthenia gravis. For example, it can be bulbar syndrome, inflammatory diseases (meningitis, encephalitis), tumor formations in the area of the brain stem (hemangioblastoma, glioma), neuromuscular pathologies (myopathy, Guillain syndrome, ALS and others), cerebrovascular accidents (ischemic instinct ) and so on.
Drug treatment of myasthenia gravis
Depending on the symptoms and stage of development of the disease, the necessary type of therapy may differ.
First of all, it is necessary to take medications that improve the transmission of impulses in neuromuscular joints. Most often, pharmacological agents such as Oxazil, Proserin, Pyridostigmine, and so on are used for these purposes. All of them have a similar type of action and increase the concentration of acetylcholine. These drugs are quite effective in getting rid of the pathology in the early stages of its development, as well as during the onset of crises.
The next thing to do is to correctly correct the water-electrolyte balance in the body. To do this, you need a sufficient intake of B vitamins in it and ensuring normal potassium metabolism.
The progression of the disease involves the adoption of more aggressive therapeutic measures. They consist of taking immunosuppressive hormones. Despite the fact that such drugs are difficult to tolerate by the body, the benefits of their use are much more significant than possible side effects, especially when it comes to preserving not only health but also life.
Note!
There are some drugs that are strictly forbidden to take with a diagnosis of myasthenia gravis. These include beta-blockers, magnesium salts, calcium antagonists, aminoglycoside antibiotics, thyroid hormones, tranquilizers, morphine, quinine derivatives, antipsychotics, barbiturates, as well as most sleeping pills and sedatives.
In addition, we must not forget that any pharmaceutical preparation can be taken only after the appointment of a doctor, taking into account all the individual characteristics of the body.
Surgical treatment
Drug therapy is not always able to bring the desired result and get rid of the problem. Therefore, often there is a need for surgical intervention. It, in turn, may include one or more procedures:
- mechanical ventilation of the lungs with the impossibility of independent breathing;
- plasmapheresis for purification of blood from abnormal antibodies, while the process itself should be carried out regularly at regular intervals;
- occupational therapy and physiotherapy - these two procedures will not relieve the disease, but will help the patient cope with fluctuations in muscle strength.
In addition, it may be necessary to remove the thymus gland with surgery.
Stem cell treatment
This type of getting rid of the problem has not yet become widespread, but still it is worth remembering about it.
Treatment with stem cells derived from adipose tissue has shown a fairly high efficiency in the fight against the disease. They contribute to the maximum extension of the period of remission. Healthy stem cells help restore breathing and swallowing. In addition, they contribute to the elimination of ptosis in the shortest possible time.
The course of treatment and the frequency of introduction of stem cells into the body can be prescribed only by an experienced specialist!
Forecast for the future
Even in the last century, the diagnosis of "Myasthenia gravis" meant an imminent death. But time passes, and medicine does not stand still. At the moment, many special preparations have been developed that help save life and extend the period of remission as much as possible.
However, we must not forget that myasthenia gravis is a chronic disease. And this means that patients will have to be on treatment all the time (constant or courses) to maintain health. It is easy to guess that the quality of life in this case can noticeably suffer.
Therefore, it is worth repeating again that only timely diagnosis of the disease is able to timely stop its progression and avoid complications.
Relapse prevention
We talked about such a pathology as myasthenia gravis. What is it, what symptoms are accompanied by the disease, and is there an effective treatment for the disease, was also discussed. In conclusion, I would like to dwell on methods for the prevention of relapses, since for patients this topic is very relevant.
Firstly, it is important to register with a neurologist. In this case, under no circumstances should you miss the scheduled appointments, and if symptoms of the disease occur, you should contact the doctor as well, without waiting for the next visit.
Secondly, it is necessary to review and, if necessary, adjust your usual way of life. In no case should patients with myasthenia gravis be physically overworked, so it is advisable to choose a job involving mental work. If possible, it is worth restricting long trips, especially with regard to public transport.
We must not forget that any disease, even acute respiratory viral infections, causes stress and malfunctions in the immune system. Therefore, it is important to carefully monitor the state of your health, to prevent hypothermia and not to be in crowded places during the period of widespread infectious diseases.
In the presence of myasthenia gravis, the intake of any medication should be agreed with the attending physician, since there are many special contraindications (some of which were mentioned above).
Do not self-medicate and be healthy!