Types of myasthenia gravis crisis

Written by Tang Bo
Neurology
Updated on September 13, 2024
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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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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 Liu Hong Mei
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Will severe myasthenia gravis swallowing difficulties improve?

Myasthenia gravis and difficulty swallowing generally improve with medication treatment. Myasthenia gravis is a neuromuscular disease that typically presents with worsened muscle weakness and swallowing difficulties during fatigue. This condition requires targeted pharmacological treatment and further repetitive stimulation, which can involve specific medications and steroids. Swallowing difficulties associated with myasthenia gravis are typical of generalized myasthenia gravis, necessitating active pharmaceutical treatment, which usually has good outcomes. Avoid overworking, staying up too late, smoking, and excessive drinking. It is important to rest sufficiently, ensure ample sleep, eat fresh vegetables and fruits, and consume high-protein, nutritious foods.

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What should people with myasthenia gravis pay attention to in their daily lives?

Patients with myasthenia gravis should be careful to continue taking their medications after being discharged from the hospital and must not change the dosage or administration of their medication on their own. It is important to avoid overexertion and emotional stimuli in daily life. One should ensure to get enough rest, maintain adequate sleep, and consume fresh vegetables and fruits. Avoid spicy, stimulating, and excitatory foods. Do not be overly sad or experience excessive emotional fluctuations. Pay attention to the risk of catching a cold and upper respiratory infections. Take precautions against exposure to cold and prevent infections. Balance work and rest, maintain regular life patterns, keep in good spirits, ensure adequate sleep, and avoid excessive emotional disturbances and stimuli.

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The difference between amyotrophic lateral sclerosis and myasthenia gravis

These two are distinctly different diseases. Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, which is a degenerative neurological condition primarily affecting the upper and lower motor neurons. Patients may exhibit symptoms such as muscle atrophy, muscle twitching, general weakness, as well as potential difficulties in swallowing, articulation disorders, and atrophy of the tongue muscles. The mechanism of this disease is not very clear, symptoms progressively worsen, and there are no effective treatment methods. Neurogenic changes can be observed in electromyography. Myasthenia gravis, on the other hand, is a typical neuromuscular junction disease caused by immune dysfunction. It presents with skeletal muscle fatigue and weakness, typically worsening in the evening. Treatment with immunosuppressants has been shown to be effective.

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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.