Myasthenia gravis: symptoms, diagnosis, treatment
To date, there are many autoimmune diseases. Some can be eliminated with the help of properly selected therapy, while others are not amenable to treatment, and the only thing that medicine can do is to prevent exacerbations.
In the article we will talk about such a pathology as myasthenia gravis: symptoms, diagnosis, treatment of the disease - all these moments we will try to discuss as much as possible. In addition, we learn who is most susceptible to the disease, whether there are ways to avoid such trouble.
What is myasthenia gravis?
Myasthenia gravis is an autoimmune disease that causes progressive weakness of the muscles. This happens as a result of failures in the neuromuscular transmission. In most cases, the muscles of the eye, chewing and facial, less often - performing respiratory function.
As the statistics show, Gravis gravis most often affects women in their age, although recently they began to register among the younger generation.
Classification of the disease
Virtually every disease can be classified by species. Gravis myasthenia was no exception. The form of the disease can depend on various factors, so consider the most common types.
Depending on the age category of the patient, myasthenia gravis may be:
- of newborns;
- of adults;
- is a late version.
Depending on the clinical signs, the following types of diseases are identified under the name of myasthenia gravis:
- ophthalmic form;
- is pharyngeal;
The symptoms of each of the types of ailment are discussed below.
Causes of the development of the disease
The root cause of the disease is still unexplored. It is only known that the ailment arises from the blocking of the receptors in the muscles by the immune system. As a result, they are not able to respond to the received nerve signals.
Myasthenia gravis disease Gravis may be congenital or acquired. The first form is much less common, and the cause of its occurrence are gene mutations.
The acquired myasthenia gravis may manifest itself against the background of thymomegaly( benign hyperplasia of the thymus gland) or tumors. Rarely, the cause of the disease can be autoimmune pathologies, for example, scleroderma or dermatomyositis.
There are many cases when myasthenia gravis developed against the background of cancer. In particular, it concerns tumors of genital organs( prostate, ovaries), less often - liver, lungs and so on.
Symptoms of the disease
What signs will make it possible to diagnose "myasthenia gravis"?Symptoms can differ or be combined depending on the form of the ailment and its stage.
Eye myasthenia gravis affects:
- circular eye muscle;
- oculomotor muscle;
- muscle, which is responsible for raising the upper eyelid.
As a result, the symptoms of this form of the disease may be as follows:
- difficulty in focusing the look;
- double vision;
- impossibility for a long time to look at distant or too close objects;
- ovulation of the upper eyelid( ptosis).
The last of the considered features can manifest itself only closer to the evening, and in the morning completely absent.
The facial myasthenia gravis is accompanied by such symptoms:
- a change in voice that becomes "nasal" and deaf;
- difficulties with speech( the patient is tired even after a few minutes of talking);
- difficulties with eating( it is very difficult for a patient to chew hard food because of weakness of the corresponding muscles).
When the pharynx is affected, there is a high probability of ingress of water into the respiratory tract. This is due to the fact that the patient is not able to take liquid food and can choke, which happens quite often. As a result, it is fraught with the development of aspiration pneumonia.
The musculoskeletal form of the disease is accompanied by increased fatigue of one or another part of the body. In most cases, this applies to the limbs. There were cases when the patient could not take even a regular cup of water or climb the stairs.
The most dangerous is the generalized form of the disease. It is manifested by the weakness of the respiratory muscles, which can lead to the development of acute hypoxia and death.
As we see, myasthenia gravis, the symptoms of which are quite diverse, is a very serious and life-threatening pathology. That is why it is important to notice the appearance of the problem in a timely manner and take all the necessary measures.
Therefore, the following items, which we consider under the theme of "Myasthenia Gravis", - diagnosis and treatment of ailment.
Myasthenia gravis is a rare disease. Therefore, the neurologist can not always quickly diagnose correctly.
What should a doctor do to diagnose a disease such as myasthenia gravis? Diagnostics may include:
- a patient interview for complaints;
- clinical examination;
- carrying out a proserin test;
- carrying out the test with eudrophonia;
- electromyographic examination;
- determination of the level of antibodies to acetylcholine receptors in serum;
- ophthalmologic examination;
- carrying out computed tomography of the chest;
- examination of the lung function.
During the study, it is important to exclude all possible diseases, the symptoms of which are somewhat similar to the manifestations of myasthenia gravis. For example, it may be bulbar syndrome, inflammatory diseases( meningitis, encephalitis), tumoral formations in the brain stem( hemangioblastoma, glioma), neuromuscular pathologies( myopathy, Guillain syndrome, ALS and others), cerebrovascular disorders( ischemic instult) and so on.
Medical treatment of myasthenia gravis
Depending on the symptoms and the stage of the disease development, the necessary type of therapy may differ.
First of all, it is necessary to take medications that help to improve the transmission of impulses in neuromuscular junctions. Most often, pharmacological agents such as "Oksazil", "Proserin", "Pyridostigmine" and so on are used for these purposes. They all have a similar type of action and increase the concentration of acetylcholine. These drugs are quite effective in getting rid of pathology in the early stages of its development, as well as during the onset of crises.
The next thing to do is correct the water-electrolyte balance in the body. To do this, you need sufficient intake of B vitamins in it and ensure a normal metabolism of potassium.
Progression of the disease involves the adoption of more aggressive therapies. They consist in the reception of immunosuppressive hormones. Despite the fact that such drugs are difficult to tolerate by the body, the benefits from their use are much greater than the possible side effects, especially when it comes to preserving not only health, but also life.
There are some drugs that are strictly forbidden to take with the diagnosis of "myasthenia gravis."These include beta-blockers, magnesium salts, calcium antagonists, antibiotics-aminoglycosides, thyroid hormones, tranquilizers, morphine, quinine derivatives, neuroleptics, barbiturates, and most of the hypnotics and sedatives.
In addition, we must not forget that any pharmaceutical product can be taken only after the appointment of a doctor taking into account all the individual characteristics of the body.
Treatment with surgical intervention
Medication therapy is not always able to bring the desired result and to get rid of the problem. Therefore, there is often a need for surgical intervention. It, in turn, can include one or more procedures:
- mechanical ventilation of lungs when self-breathability is not possible;
- plasmapheresis for purifying blood from abnormal antibodies, while the process itself should be performed regularly at regular intervals;
- occupational therapy and physiotherapy - these two procedures will not relieve the disease, but will help the patient cope with fluctuations in muscle strength.
In addition, it may be necessary to remove the thymus gland by surgical intervention.
Stem cell treatment
This kind of getting rid of the problem has not yet acquired a wide spread, but it is worth remembering about it.
Treatment with stem cells derived from adipose tissue has shown a fairly high effectiveness in the fight against the disease. They contribute to the maximum prolongation of the period of remission. Healthy stem cells help to restore the processes of breathing and swallowing. In addition, they contribute to the elimination of ptosis as soon as possible.
The course of treatment and the frequency of introduction of stem cells into the body can be prescribed only by an experienced specialist!
Forecast for the future
In the last century, the diagnosis of "myasthenia gravis" meant imminent death. But time goes by and medicine does not stand still. At the moment, many special preparations have been developed that help to save life and maximize the period of remission.
However, one must not forget that myasthenia gravis is a chronic disease. And this means that patients will have to stay on treatment( constant or courses) all the time to maintain health. It is easy to guess that the quality of life in this case can be significantly affected.
Therefore it is worth repeating once again that only timely diagnosis of the disease is able to timely stop its progression and avoid complications.
We talked about such a pathology as myasthenia gravis. What is it, what symptoms accompanied the disease and whether there is an effective treatment of the disease, also discussed. Finally I would like to dwell on the methods of preventing relapses, since this topic is very relevant for patients.
First, it is important to register with a neurologist. At the same time, in no case should you miss the planned methods, and if symptoms of the disease occur, you should contact the doctor and fight without waiting for the next visit.
Secondly, it is necessary to revise and, if necessary, adjust your habitual way of life. Myasthenia gravis should never be physically fatigued, so it is advisable to choose a job that involves mental work. If possible, it is worthwhile to limit long trips, especially with regard to public transport.
It should not be forgotten that any disease, even SARS, causes stress of the body and malfunctions in the immune system. Therefore, it is important to carefully monitor your health, prevent hypothermia and not be in places of large concentrations of people during a period of widespread infectious diseases.
In the presence of myasthenia gravis, the intake of any medication must be agreed with the attending physician, since there are a number of special contraindications( some of them were recalled above).
Do not self-medicate and stay healthy!