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Myasthenia Gravis
Does myasthenia gravis hurt?
Myasthenia gravis does not cause pain. Initially, patients with myasthenia gravis may feel discomfort such as soreness or swelling in the eyes or limbs, blurred vision, or fatigue. As the condition progresses, skeletal muscles become noticeably fatigued and weak. A significant characteristic is muscle weakness, which worsens after exertion in the afternoon or evening and improves after rest in the morning, known as "morning better, evening worse." Patients with myasthenia gravis can experience involvement of skeletal muscles throughout the body, manifesting as drooping eyelids, blurred vision, double vision, strabismus, restricted eye movements, bland facial expressions, a "forced smile" appearance, speech impairments resembling a thick tongue often accompanied by a nasal sound. Additionally, they may have chewing difficulties, coughing or choking when drinking, swallowing difficulties, trouble raising the head, weak shoulder shrugging, difficulty lifting arms, combing hair, climbing stairs, squatting, and getting into vehicles, primarily due to muscle weakness, which does not lead to pain.
Types of myasthenia gravis crisis
Myasthenic crises are categorized into three types, all resulting from worsening conditions or improper treatment, leading to respiratory muscle weakness or paralysis and subsequent difficulty in breathing. The first type occurs due to various triggers or reduction in medication, or after the application of acetylcholinesterase inhibitors which temporarily alleviate the crisis, known as the cholinergic crisis. The second type is a result of excessive use of acetylcholinesterase inhibitors during a cholinergic crisis. Beyond respiratory difficulties, symptoms may also include signs of toxicity such as vomiting, abdominal pain, diarrhea, pupil constriction, excessive sweating, drooling, increased tracheal secretions, and potential muscle tremors, spasms, as well as anxiety, insomnia, confusion, seizures, and coma. The third type is the paradoxical crisis, where neither ceasing nor increasing medication doses alleviates the symptoms, typically occurring after long-term, high-dose medication use.
Myasthenia Gravis should be seen by which department?
Myasthenia gravis is considered a neurological disease, so if myasthenia gravis is suspected, it is advisable to consult a neurologist. Neurologists are quite familiar with myasthenia gravis, especially those who specialize in its research. They are particularly knowledgeable about diagnosing and treating this disease. Myasthenia gravis is an autoimmune disease of the nervous system that primarily affects the neuromuscular junction, causing muscle weakness in the body. The symptoms typically worsen towards the evening and include pathological fatigue. Muscle weakness usually improves after rest. Clinical manifestations also include ptosis, double vision, difficulty swallowing, and coughing while drinking. Neurologists may prescribe various diagnostic tests such as electromyography, chest CT scans, and tests for acetylcholine receptor antibodies.
Myasthenia gravis should be seen in the Neurology department.
Patients with myasthenia gravis should consult the department of neurology, as myasthenia gravis is an immune-related neuromuscular junction disorder. Patients often exhibit pathological fatigue, skeletal muscle involvement, and unaffected smooth muscles. The most common type is ocular myasthenia, followed by mild and moderate generalized forms. Adult patients often have thymomas or thymic hyperplasia. Upon diagnosis of myasthenia gravis, it is essential to perform a comprehensive thymic CT scan. If thymic abnormalities are present, referral to thoracic surgery for treatment is needed. If there is no thymic disease, high-dose steroid pulse therapy may be considered. Additionally, it is crucial to determine whether the patient has other coexisting immune abnormalities, such as hyperthyroidism or connective tissue disease, and tailor the treatment accordingly.
incidence of myasthenia gravis
Myasthenia gravis is a disease of the neurology department. Its incidence rate is around one in one hundred thousand. The prevalence rate is around fifty per one hundred thousand. In China, the incidence rate in the south is slightly higher than in the north. This is an autoimmune disease of the nervous system. Generally, it is due to the production of some abnormal antibodies. These antibodies cause dysfunction in synaptic transmission at the neuromuscular junction, leading to corresponding clinical manifestations in patients. For example, extreme fatigue after physical activity that can only be alleviated by rest. Patients may also exhibit clinical symptoms such as ptosis, diplopia, and difficulty swallowing, and in severe cases, even respiratory muscle weakness may occur, requiring the use of a ventilator. This disease can occur at any age, affecting children as well as elderly men aged 70 to 80. Therefore, correct understanding of this disease and timely treatment are very important.
Does myasthenia gravis cause sensitivity to cold?
Patients with myasthenia gravis tend to be sensitive to cold, mainly due to the following factors: Firstly, patients with myasthenia gravis generally experience overall weakness and have very limited physical activity, making their physique rather frail. Patients with a weak physique are definitely more susceptible to colder environments. Secondly, patients with myasthenia gravis have lower resistance to diseases and often take immunosuppressants for a long time, making them highly susceptible to respiratory and lung infections. In cold conditions, some viruses can exploit this weakness, leading to exacerbated lung and respiratory infections, which is another major reason why patients with myasthenia gravis are sensitive to cold. Thirdly, myasthenia gravis is an autoimmune disease that leads to immune dysfunction. This immune dysfunction makes patients particularly sensitive to cold stimuli. In a cold environment, their immune function may become even more disordered, contributing further to their sensitivity to cold.
Myasthenia Gravis Clinical Manifestations
The clinical manifestations of myasthenia gravis include fluctuating weakness of specific striated muscles that is fatigue-prone. Symptoms are generally milder in the morning and worsen by night, increasing after sustained activity and alleviating after rest. Additionally, some patients may experience ocular muscle weakness, presenting with ptosis and diplopia, which could be among the earliest symptoms. Eye movement disorders may occur, preventing the eyes from looking to one side, and pupil abnormalities may be present. Facial muscle weakness can lead to cheek puffing and air leakage, inability to close the eyes, or asymmetry of the mouth, resembling a forced smile. There may also be weakness in the masticatory muscles, leading to difficulties in chewing and swallowing, potential speech impairments, and coughing when drinking water. Neck muscle weakness may manifest as difficulty in lifting the head. Muscle weakness can affect various limbs, primarily proximally, and respiratory muscle weakness can lead to breathing difficulties and dryness.