Myasthenia gravis is a chronic disorder characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. It’s caused by breakdown in the normal communication between nerves and muscles.
Myasthenia gravis (MG) is a chronic autoimmune disorder that results in progressive skeletal muscle weakness. MG causes rapid fatigue (fatigability) and loss of strength upon exertion that improves after rest. Myasthenia gravis is caused by a defect in the transmission of nerve impulses to muscles. Normally when impulses travel down the nerve, the nerve endings release a neurotransmitter substance called acetylcholine. In myasthenia gravis, antibodies produced by the body’s own immune system block, alter, or destroy the receptors for acetylcholine.
Types of Myasthenia gravis
Myasthenia gravis can be classified according to which skeletal muscles are affected. Within a year of onset, approximately 85–90% of patients develop generalized myasthenia gravis, which is characterized by weakness in the trunk, arms, and legs.
About 10–15% of patients have weakness only in muscles that control eye movement. This type is called ocular myasthenia gravis.
Other types of MG include congenital, which is an inherited condition caused by genetic defect, and transient neonatal, which occurs in infants born to mothers who have MG. Congenital MG develops at or shortly after birth and causes generalized symptoms.
Transient neonatal MG is a temporary condition that develops in 10–20% of infants born to mothers who have MG. Transient neonatal MG is caused by circulation of the mother’s antibodies through the placenta and it lasts as long as the mother’s antibodies remain in the infant (usually a few weeks after birth).
Incidence and Prevalence of Myasthenia gravis
Myasthenia gravis affects approximately 2 out of every 100,000 people and can occur at any age. It is most common in women between the ages of 18 and 25. In men, the condition usually develops between 60 and 80 years of age.
Symptoms of Myasthenia gravis
- Double vision
- Loss of normal facial expression
- Drooping of eyelids
- Difficult swallowing
- Weakness of the arms and legs
- Difficult clear speech
- Dyspnoea or difficult breathing
- Decreased functions of arms, legs, and neck muscles
- Weakness of intercostal muscles
- Impaired gas exchange
- Impaired motor movements
- Condition gets flared up after a brief period of normal muscle function and aggravated as the muscle is used.
Complications of myasthenia gravis
- Ocular and facial complications- Difficulty in closing eyes, aspiration, impaired communications and nutrition
- Musculoskeletal complications- Inability to perform ADLs and self activities, complications related to immobility, myasthenic and cholinergic crises.
- Respiratory complications- Decreased ability to walk, eat, and perform other ADLs, pneumonia
- Nutritional complications- Weight loss, dehydration, malnutrition, aspiration.
Diagnosis of myasthenia gravis
- Diagnosis mainly depends upon observation of symptoms, physical examination, and history.
- Repeated muscle use over a very short period of time that fatigues and then improves with rest suggest a diagnosis of myasthenia gravis.
- Tests for this neurological condition record the effect of exercise and subsequent rest on muscle weakness.
- Electromyography, with repeated neural stimulation, may help confirm the diagnosis.
- The classical proof of myasthenia gravis is improved muscle function after an I.V. injection of anticholinesterase drugs.
- In myasthenic patients, muscle function improves within 30 to 60 seconds and lasts up to 30 minutes. Long standing ocular muscle dysfunction may fail to respond to such testing.
- This test can differentiate a myasthenic crisis from cholinergic crisis caused by acetylcholine over activity at the neuromuscular junction). The acetylcholine receptor antibody titer may be elevated in generalized myasthenia.
Conventional Treatment for Myasthenia gravis
Myasthenia gravis can be controlled. Some medications (Cholinesterase inhibitors, such as pyridostigmine (Mestinon) and corticosteroids) improve neuromuscular transmission and increase muscle strength, and some suppress the production of abnormal antibodies. These medications must be used with careful medical followup because they may cause major side effects. Thymectomy, the surgical removal of the thymus gland (which often is abnormal in myasthenia gravis patients), improves symptoms in certain patients and may cure some individuals, possibly by re-balancing the immune system. Other therapies include plasmapheresis, a procedure in which abnormal antibodies are removed from the blood, and high-dose intravenous immune globulin, which temporarily modifies the immune system and provides the body with normal antibodies from donated blood.
Homeopathy Treatment & Homeopathic Remedies for Myasthenia gravis
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc.
Following homeopathic medicines have been found effective in many cases of Myasthenia gravis:
- Calcarea carb
- Plumbum met
- Nux vomica
- Rhus tox
- Weakness of every muscle.
- Affect primarily to the voluntary muscle system then sensorium.
- In muscular system it produces paralysis and titanic convulsion and in sensorium it produces vertigo and confusion.
- Paralytic weakness in muscle.
- Weakness of cervical muscles, cannot support head.
- Painful stiffness in neck when moving it.
- Hands feel numb and asleep.
- Paralytic immobility of lower limbs.
- Numbness of sloes go to sleep while sitting.
- Muscular paralysis.
- People lack of vital heat, prematurely old people due to debility.
- Heaviness, staggering and sluggishness with very bad constipation are the characteristics of the remedy.
- Extremities feel paralyzed; leg feels asleep specially when sitting with legs crossed.
- Heels feel numb, tenderness in soles, feel soft and swollen.
- Inability to walk especially when eyes are open or in daytime.
- Paralysis of various groups of muscles about the eyes, throat, chest, larynx, sphincter, extremities, etc.
- Muscular weakness. Complete relaxation and prostration. Lack of muscular co-ordination
- General prostration. Dizziness, drowsiness, dullness, and trembling.
- Loss of power of muscular control.
- Excessive trembling and weakness of all limbs. Hysteric convulsions.
- Fatigue after slight exercise.
- Conium is an excellent remedy, such as difficult gait, trembling, sudden loss of strength while walking, painful stiffness of legs.
- It corresponds to the debility, hypochondriasis, urinary troubles, weakened memory, sexual debility found here.
- Great debility in the morning in bed.
- Weakness of body and mind, trembling, and palpitation.
- Muscular paralysis without impairing sensation and consciousness.
- Paralysis of respiratory muscles.
- Reflex action diminished
- Tired pain up and down spine.
- Arms weak, heavy. Cannot lift the fingers.
- Weakness of hands and fingers in pianists.
- Legs tremble; give way in walking. Debility; paralysis.