Symptoms of Myasthenia Gravis

Common Symptoms

Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles. It can affect people of any age, but it is more common in females under age 40 and males over age 60. Here are the common symptoms of myasthenia gravis and how to treat or mitigate them:

Muscle Weakness: The hallmark symptom of myasthenia gravis is muscle weakness. This weakness tends to worsen after periods of activity and improve after periods of rest. The degree of muscle weakness can vary greatly among individuals.
Eye and Eyelid Weakness: People with myasthenia gravis may experience weakness in the muscles that control eye and eyelid movement. This can result in drooping eyelids, blurred or double vision, and difficulty with eye movements.
Facial Weakness: Weakness in the facial muscles can affect facial expressions, causing changes in facial appearance.
Difficulty Swallowing and Chewing: Myasthenia gravis can also lead to difficulty swallowing or chewing due to muscle weakness in the throat and mouth.
Difficulty Speaking: Impaired speech, known as dysarthria, can occur as a result of muscle weakness in the tongue and throat.
Weakness in Limbs: Muscle weakness may also affect the arms, hands, fingers, legs, and neck.
Respiratory Failure (in severe cases): In rare cases, myasthenia gravis can cause severe weakness that affects respiratory muscles, leading to difficulty breathing. This requires immediate emergency medical care.

To treat or mitigate these symptoms, early intervention is important. Although there is no cure for myasthenia gravis, treatment options include:

Lifestyle Changes: Making certain lifestyle modifications such as conserving energy, avoiding stressors that worsen symptoms, and taking regular rest breaks can help manage muscle weakness.
Medications: Medications that increase muscle strength by preventing the breakdown of acetylcholine (a neurotransmitter) or reduce the activity of the immune system may be prescribed by a healthcare professional.
Surgery: In some cases, surgery may be recommended to remove the thymus gland if it is associated with myasthenia gravis.

It's important for individuals experiencing symptoms of myasthenia gravis to seek medical attention from their doctor for proper diagnosis and treatment guidance. With early treatment and management strategies, disease progression can be limited and muscle weakness can be improved.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.

Common Symptoms in More Severe Disease

Myasthenia gravis is a neuromuscular disorder that can cause a range of symptoms. The severity and progression of MG can vary from person to person. Here are some symptoms of more severe or progressed MG:

Muscle weakness: MG primarily affects voluntary skeletal muscles, which are the muscles we can control. People with MG may experience weakness in their arms, hands, legs, or feet.
Drooping eyelids: One common symptom of MG is eyelid drooping, also known as ptosis. This can occur in one or both eyelids.
Double vision: Another common symptom is double vision, also called diplopia. This occurs when the muscles that control eye movement are weakened.
Trouble speaking: Weakness in the muscles involved in speech can make it difficult for people with MG to speak clearly. Their voice may become weak and quiet.
Difficulty swallowing or chewing: MG can affect the muscles involved in swallowing, making it challenging to eat and drink. This can include difficulty swallowing solid foods, liquids, and even pills.
Fatigue: Many people with MG experience fatigue, which may worsen during periods of activity but improve after resting.
Respiratory difficulties: In severe cases of MG, respiratory muscles can become weakened, leading to difficulty breathing and shortness of breath. This can be life-threatening and may require assisted ventilation.

To treat or mitigate these symptoms, there are several options available, including:

Medication: Cholinesterase inhibitors, such as pyridostigmine, can help improve communication between nerves and muscles. However, the effects of these medications only last for a few hours.
Immunosuppressive drugs: Medications like azathioprine and glucosteroids (e.g., prednisolone) may be prescribed to alter the immune system's response and reduce the production of antibodies that cause MG symptoms. These drugs are typically used during MG crises or for long-term symptom prevention.
Monoclonal antibodies: Eculizumab is a monoclonal antibody approved by the FDA for adults who test positive for specific antibodies associated with MG. It is taken daily to prevent symptoms.
Thymectomy: Surgical removal of the thymus gland may benefit some people with MG, even if they do not have a thymus tumor.
Other treatments: In severe or life-threatening cases, additional treatments may be administered in the hospital setting.

In addition to medical treatments, self-care plays an important role in managing MG symptoms:

Getting enough rest and sleep
Listening to your body and pacing yourself throughout the day
Incorporating nutritious foods into your diet
Avoiding extreme temperatures
Engaging in physical activity when energy levels are high
Learning relaxation techniques like meditation to manage stress
Regularly seeing your doctor and following their prescribed treatment plan

It's important to work closely with healthcare professionals who specialize in neuromuscular disorders to develop an individualized treatment plan that addresses your specific needs and symptoms.

Symptoms of a Condition Flare-up

During a flare-up or exacerbation of myasthenia gravis, individuals may experience a worsening of symptoms. Some common symptoms of a flare-up or exacerbation of MG include:

Muscle weakness: This is a hallmark symptom of MG and can affect various muscles in the body, including those responsible for controlling facial expression, swallowing, and breathing.
Fatigue: People with MG may feel extremely tired or fatigued during a flare-up.
Difficulty speaking: Weakness in the muscles responsible for speech can make it challenging to speak clearly during a flare-up.
Difficulty swallowing: Weakness in the muscles involved in swallowing can lead to difficulty swallowing food or liquids.
Breathing difficulties: In severe cases, MG can affect the muscles involved in breathing, leading to shortness of breath or respiratory distress.

If you experience a flare-up of MG symptoms, there are several steps you can take to manage and treat it:

Rest: Taking time to rest and conserve energy is important during a flare-up. Avoid overexertion and give your body the opportunity to recover.
Medication: Your doctor may prescribe medications to help manage the symptoms of MG and reduce the severity of a flare-up. These medications may include anticholinesterase inhibitors, immunosuppressants, or other drugs that target the underlying immune response.
Stress management: Stress can worsen MG symptoms, so finding effective stress management techniques can be helpful. This may include activities such as deep breathing exercises, meditation, or engaging in hobbies that promote relaxation.
Hygiene and infection prevention: Practicing good hygiene, such as washing your hands regularly and avoiding close contact with individuals who have contagious illnesses, can help prevent infections that could trigger or worsen a flare-up.
Temperature management: Extreme temperatures, both hot and cold, can potentially worsen MG symptoms. It's important to avoid prolonged exposure to extreme temperatures when possible.
Adjusting exercise routine: Regular exercise is generally encouraged for individuals with MG, but during a flare-up, it may be necessary to adjust your exercise routine. Talk to your doctor about whether you should continue exercising during a flare-up or if modifications are needed.

It's important to note that while there is no cure for MG, treatment options are available to help control symptoms and improve quality of life. If you experience a flare-up or exacerbation of symptoms, it's essential to reach out to your healthcare provider for guidance on managing your specific situation.

Warning Signs

If you or a loved one have MG and experience any of the following warning signs, it is important to contact your doctor or seek medical help right away:

Difficulty breathing: If you are having trouble breathing, it could be a sign of respiratory failure related to MG. This is also known as a myasthenic crisis and is a medical emergency. Up to 1 in 5 people with MG will experience a myasthenic crisis in their lives, usually within the first 2 years of having the disease.
Shallow breathing: If you notice that your breathing becomes shallow, it could be a symptom of a myasthenic crisis. This can develop over several hours, days, or weeks, but sometimes it can happen more quickly.
Weak cough: A weak cough can be an indication of muscle weakness in the respiratory muscles, which can occur during a myasthenic crisis.
General weakness: If you experience a general feeling of weakness throughout your body, it could be a sign of worsening MG symptoms.
Weakness in limbs: Muscle weakness in the arms and legs is common in people with MG. If you notice increased weakness in your limbs, it may be a warning sign that your condition is worsening.
Increased bulbar weakness: Bulbar weakness refers to weakness in the muscles involved in speech and swallowing. Signs of increased bulbar weakness may include drooling, lip trembling, loss of gag reflex, tongue or jaw weakness, difficulty swallowing or talking, and nasal or hoarse voice.

Remember that early treatment is important to improve your outcome if you suspect you may be experiencing a myasthenic crisis or if your symptoms are worsening. It's always best to consult with your doctor for proper evaluation and guidance tailored to your specific situation.