Myasthenia Gravis Clinical Manifestations

Written by Tang Bo
Neurology
Updated on September 01, 2024
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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.

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Written by Zhang Hui
Neurology
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Where should I go for treatment of myasthenia gravis?

Myasthenia gravis is classified as a neurology disease. Therefore, patients should visit the neurology department for medical consultation. Fundamentally, it is an immune disorder of the nervous system characterized by the production of abnormal antibodies. These antibodies affect the acetylcholine receptors on the postsynaptic membrane, thereby impacting the transmission of nerve impulses at the neuromuscular junction, which leads to various clinical symptoms. Patients may experience ptosis, double vision, and potentially compromised swallowing function, causing overall weakness. Symptoms typically worsen towards the evening. Many patients also present with thymus abnormalities. Treatment generally involves oral medications, predominantly corticosteroids and cholinesterase inhibitors.

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Written by Zhang Hui
Neurology
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What should not be eaten in the case of myasthenia gravis?

Myasthenia gravis is an autoimmune disease of the nervous system, primarily due to dysfunction at the neuromuscular junction, leading to skeletal muscle fatigue. Symptoms include drooping eyelids, double vision, overall weakness, and even swallowing difficulties. Foods that should be avoided in myasthenia gravis mainly include certain medications, such as aminoglycoside antibiotics, which should not be taken orally by patients, as well as fluoroquinolone antibiotics. These antibiotics can exacerbate neuromuscular transmission disorders, potentially worsening the disease. Additionally, benzodiazepines, barbiturates, and some anti-arrhythmic drugs can also reduce muscle membrane excitability and should be avoided.

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Written by Zhang Hui
Neurology
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Is it dangerous to have a fever with myasthenia gravis?

Myasthenia gravis is a disease of the neuromuscular junction, essentially an autoimmune inflammatory response that causes generalized weakness and fatigue of the skeletal muscles, with symptoms that are less severe in the morning and worsen by the evening, and fluctuate over time. The weakness can be alleviated by rest. When patients with myasthenia gravis develop a fever, it is generally considered to be caused by an infection, perhaps a viral infection such as an upper respiratory tract infection, which can also induce fever. In such cases, the main treatment involves drinking plenty of water and consuming fresh vegetables and fruits. If necessary, some antiviral medications and antipyretics may be administered. If the fever is due to a bacterial infection, symptomatic treatment should be accompanied by the appropriate antibiotics. However, the choice of antibiotics must be made with caution. Patients with myasthenia gravis should not use aminoglycosides or fluoroquinolones, as these could exacerbate their condition. Penicillins or cephalosporins may be used instead. (Please consult a professional physician for specific medication guidance.)

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Written by Tang Li Li
Neurology
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Can severe myasthenia gravis be cured by massage?

Myasthenia Gravis cannot be treated through massage, as it is an acquired autoimmune disease primarily caused by damage to the acetylcholine receptors at the neuromuscular junction. Treatment involves the use of immunosuppressive medications such as corticosteroids, immunosuppressants, and azathioprine. Typically, high doses of corticosteroids are administered to suppress the immune-inflammatory response and reduce the production of acetylcholine receptor antibodies, allowing a sufficient number of acetylcholine receptors to be preserved. Additionally, acetylcholinesterase inhibitors can be used to decrease the breakdown of acetylcholine and increase its concentration in the synaptic gap, thus promoting impulse transmission at the neuromuscular junction and improving symptoms of muscle weakness. The most commonly used medications in standard treatment include pyridostigmine, and corticosteroids such as methylprednisolone or prednisolone. (Please use medications under the guidance of a doctor)

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Written by Zhang Hui
Neurology
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Acupuncture treatment for myasthenia gravis

Patients with myasthenia gravis suffer from a systemic autoimmune disease, primarily affecting the neuromuscular junctions, which leads to corresponding clinical manifestations. The essence of the disease is caused by immune dysfunction, where the body produces specific antibodies that affect the transmission of impulses. Patients typically experience general weakness, double vision, drooping eyelids, and in severe cases, weakened respiratory muscles leading to respiratory paralysis. The treatment of myasthenia gravis mainly involves medication, including corticosteroids, immunoglobulins, acetylcholinesterase inhibitors, and other immunosuppressants. Additionally, there are some newer drugs that modulate the immune system. Acupuncture treatment, as an important method of traditional Chinese medicine, can also be used in the management of myasthenia gravis, primarily to improve the patients' resistance, enhance physical constitution, and play a significant role in preventing complications and reducing the dosage of other medications. (Specific medications should be administered under the guidance of a physician.)