Can myasthenia gravis be cured completely?

Written by Zhang Hui
Neurology
Updated on September 20, 2024
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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
Neurology
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What medicine should be taken for myasthenia gravis?

Myasthenia gravis is a type of neurological immunological disease in neurology, mainly caused by a disorder of the body's own immune function. Patients in the body will produce antibodies against acetylcholine receptors, thus affecting the transmission of nerve impulses at the neuromuscular junction. For this disease, the following medications are generally prescribed: The first type of medication is a cholinesterase inhibitor, which can increase the amount of acetylcholine at the neuromuscular junction, thereby effectively improving clinical symptoms. The second type of medication is corticosteroids, because this disease is caused by an abnormal inflammatory response. Therefore, taking corticosteroids can suppress the inflammatory response. Treatment generally starts with a small dose and gradually increases, maintaining for a period before gradually tapering off. It may also be necessary to take other immunosuppressants. (Please take the medication under the guidance of a doctor)

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Written by Tang Bo
Neurology
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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.

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Written by Tang Bo
Neurology
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Myasthenia Gravis Best Treatment

The treatment of myasthenia gravis should also be individualized, specifically based on the actual condition of the patient. First and foremost, a clear diagnosis is essential. Once the diagnosis is confirmed, cholinesterase inhibitors can be used, but the dosage and frequency must be decided based on the patient's individual condition. Additionally, if the patient has a thymoma or thymic hyperplasia, a surgeon should determine whether surgical treatment is necessary. It is also necessary to consider whether to use steroids or plasmapheresis. In the event of a myasthenic crisis, symptomatic treatment should be provided according to the situation to maintain the patient's vital signs, and it is crucial to diagnose and treat early.

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Written by Tang Bo
Neurology
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Myasthenia gravis initial symptoms

Myasthenia gravis is characterized by fluctuating and fatigue-prone muscle weakness in certain specific striated muscles. Symptoms are generally milder in the morning and more severe in the evening, worsening with continued activity and alleviating after rest. The most common initial symptom is weakness of the external eye muscles, primarily presenting as asymmetrical ptosis (drooping of the upper eyelid) or narrowing of the eye slit, along with diplopia, which refers to seeing double images. These are the most frequent initial symptoms, seen in over 50% of patients with myasthenia gravis. Additionally, some patients may experience disturbances in eye movement, facial muscle weakness, air leakage when puffing cheeks, incomplete eyelid closure, shallower nasolabial folds, as well as difficulty swallowing, speech articulation issues, choking while drinking, and potentially severe respiratory weakness.

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Written by Zhang Hui
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Types of Myasthenia Gravis Crisis

Myasthenia gravis is a neurological disease. It is an autoimmune disorder primarily affecting the neuromuscular junction, leading to symptoms such as pathological fatigue, ptosis, and limb weakness. Myasthenia gravis is termed as such due to its severe nature, including crises that can impair respiratory muscles, leading to respiratory paralysis, respiratory failure, and potentially death. There are three main types of myasthenic crises. The first type is myasthenic crisis, primarily caused by insufficient medication; muscular injections can be used for treatment, and if effective, it indicates a myasthenic crisis. The second type is called cholinergic crisis, resulting from an overdose of acetylcholinesterase inhibitors, with symptoms including muscular twitching and pupil constriction. The third type is called refractory crisis, occurring when the body is insensitive to medication treatments. All these crises pose a life-threatening risk to patients and require immediate management, including tracheal intubation and, if necessary, mechanical ventilation.