Myasthenia Gravis FAQs
Myasthenia gravis (MG) is a neuromuscular disease that weakens different muscles in the body.
Like lupus or rheumatoid arthritis, myasthenia gravis is an autoimmune disorder, meaning the body's own immune system attacks itself. In myasthenia gravis, the system attacks the connections between nerve and muscle.
MG can affect people of all ages, although it is most common in women younger than 40 and men older than 60. The muscle weakness can be seen in different ways depending on the severity of the disease, the cause of which remains unknown. If it is not diagnosed or treated, problems can become life-threatening.
Learn more about myasthenia gravis.
For example, Myasthenia gravis patient Vicki Ruddy wound up in an emergency room because she was extremely weak-having trouble both moving and breathing. It turned out to be a result of an enlarged thymus gland (which is active during childhood and is important to the immune system but which typically atrophies in adulthood). Ruddy had surgery to remove a tumor from the gland about six months after her diagnosis.
Myasthenia gravis symptoms can include:
- Breathing difficulties
- Problems chewing and swallowing (choking)
- Facial muscle weakness or paralysis such as eyelid drooping
- Difficulty talking
- Difficulty climbing stairs
- A drooping head
It can be diagnosed through a variety of means, including examination, blood tests and electrical tests.
Although it has no cure, MG is controllable with medications and patients learn to adapt. It is not a neuro-degenerative disease-typically patients do not get worse over time, as they might with other neurological diseases such as amyotrophic lateral sclerosis (ALS) or Alzheimer's.
Michael Cartwright, MD, a Wake Forest Baptist Health physician with expertise in neuromuscular diseases, answers common questions about MG.
We know that myasthenia gravis is not an easily diagnosed disease, because its most common symptoms also can indicate other issues. How is it that you find most patients are diagnosed with MG?
Most patients have a set of symptoms, and a lack of other symptoms, and when they are considered together, they point physicians, and neurologists in particular, toward the diagnosis of MG. To confirm the diagnosis there are a variety of tests, including blood work and electrical tests of nerves and muscles.
What are patients' biggest concerns when faced with a diagnosis and how do you reassure them?
Patients are often initially concerned because it is a disease with which they are not familiar. So education about the disease, and the treatment options, helps during the first visit. The other issue that concerns patients with MG is the idea of having an MG crisis. A crisis occurs when the symptoms of myasthenia gravis dramatically worsen, and it concerns patients because on occasion it can happen rapidly. However, there are usually warning signs, and treating MG makes patients much less likely to ever experience a crisis.
What are the likely courses of treatment recommended today for myasthenia gravis? Does this differ much from years past?
Several decades ago, there were no treatments for MG, which made it a life-threatening condition. Over the past few decades, treatment with medications that suppress the immune system and control the symptoms of MG have been developed, and MG is now a very treatable disease. Most of these treatments are medications that are taken by mouth, but some intravenous treatments are also used.
Statistics show more people being diagnosed with myasthenia gravis, probably because it is more widely recognized and people are getting better about reporting symptoms of muscle weakness. What do you see as the future in treatment of MG?
We now have several options to successfully treat and control MG, so in the future I think we will focus on determining which treatments are the best and have the fewest side effects. This may differ for each patient, so we will be studying how to choose treatments based on each patient's unique situation.
You encouraged one of your patients with a support group for people with MG. How does a support group help?
Having an myasthenia gravis support group is a great asset for patients. It allows them to discuss their disease with others in the same situation, which helps them understand their condition better. Since MG is treatable, it also allows patients that were just diagnosed with the disease to meet other patients that have been leading active lives with MG for many years.