How is myasthenia gravis diagnosed?

Written by Zhang Hui
Neurology
Updated on September 15, 2024
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Myasthenia gravis is essentially an immunoreactive disease in neurology, primarily caused by immune dysfunction in the body, leading to the production of autoantibodies. These antibodies attack the acetylcholine receptors on the postsynaptic membrane, resulting in corresponding clinical symptoms such as ptosis, diplopia, and general fatigue. The examination of myasthenia gravis mainly includes the following aspects: first, the completion of the Tensilon test, and if the test is positive, myasthenia gravis should be considered; second, the examination should include repetitive nerve stimulation electromyography, and if there is a significant decrement in wave amplitude, this disease should be considered; third, relevant blood tests should be conducted, mainly to check for acetylcholine receptor antibodies, as positive results for these antibodies are important in supporting this diagnosis.

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Written by Zhang Hui
Neurology
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Can myasthenia gravis be cured completely?

Myasthenia gravis is a relatively common disease in neurology. Whether it can be completely cured mainly depends on the severity of the disease and some of its subtypes. For instance, patients with ocular myasthenia gravis only exhibit symptoms such as ptosis; by using some corticosteroids or acetylcholinesterase inhibitors, some patients can be cured. However, there are also patients who experience generalized muscle weakness, which is particularly severe and may even affect the respiratory muscles. These patients need long-term or even lifelong medication to prevent the recurrence of severe myasthenia gravis. Additionally, some patients with myasthenia gravis also have thymomas, and many patients can be cured after the removal of the thymoma. Therefore, most cases of myasthenia gravis cannot be completely cured and require long-term medication, though a small portion might be curable.

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Written by Zhang Hui
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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.

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Written by Zhang Hui
Neurology
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Myasthenia gravis should not use what medicine?

Myasthenia gravis is a neuromuscular junction disease in neurology, primarily due to some synaptic dysfunction, leading to pathological fatigue and general weakness in patients. Patients with myasthenia gravis often experience exacerbation of the disease due to fatigue or infection, and certain medications can severely affect synaptic function, worsening the condition, and are therefore not to be used. The medications to avoid mainly include the following types: The first type is aminoglycoside antibiotics, which can exacerbate the transmission at the neuromuscular junction. Second, quinolone antibiotics should also be avoided as much as possible. Third, some antiarrhythmic drugs can also decrease the excitability of the fascia and are not recommended. Additionally, some drugs like morphine, benzodiazepines, and receptor blockers should also be contraindicated or used with caution.

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Neurology
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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.

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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.