Myasthenia gravis is a chronic autoimmune, neuromuscular disease that leads to weakness and rapid fatigue in any of the muscles under voluntary control. It is caused by a breakdown in the communication between the nerves and muscles. Specifically, antibodies block, destroy, or alter the receptors for the neurotransmitter acetylcholine at the neuromuscular junction, preventing the muscle from contracting.
Myasthenia gravis is not hereditary or contagious. It is more common in women younger than 40 and men older than 60.
Muscle weakness with myasthenia gravis worsens with periods of activity and improves after periods of rest. While it can affect any of the muscles that are controlled voluntarily, certain muscle group are more commonly affected than other. Common symptoms include:
- Weakness of the eye muscle (ocular myasthenia)
- Drooping of eyelid(s) (ptosis)
- Blurred or double vision (diplopia)
- Difficulty swallowing
- Shortness of breath
- Impaired speech (dysarthria)
- Weakness in the arms, hands, fingers, legs, and neck
A myasthenic crisis can occur when the muscles that control breathing become weak to the point where a ventilator is required to assist with breathing. About 15 to 20 percent of people with myasthenia gravis will experience at least one myasthenic crisis.
- Neurological examination
- Blood analysis (to look for the presence of abnormal antibodies)
- Repetitive nerve stimulation
- Single-fiber electromyography (EMG)
- CT scan or MRI (to look for a tumor or abnormality on the thymus)
- Pulmonary function tests
While there is no cure for myasthenia gravis, a variety of treatment is available to help manage the symptoms.
Since the thymus gland controls immune function and may be associated with myasthenia gravis, one course of treatment is a thymectomy, with about 50% of individuals who undergo this procedure experiencing remissions. Other treatments include:
- Medications (cholinesterase inhibitors, corticosteroids, immunosuppressants)
- Intravenous therapy (plasmapheresis, intravenous immunoglobulin, monoclonal antibody)
Because myasthenia gravis can improve with rest, and can go into periods of remission, it can be difficult to prove up to an insurance company even if it has impacted your ability to practice to the point you need to file a claim. If you have been diagnosed with myasthenia gravis and feel you may no longer be able to safely practice, please feel free to reach out to one of our attorneys directly.
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described above and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms
National Institute of Neurological Disorders and Stroke
Myasthenia Gravis Foundation of America