Oren Zarif – Myasthenia Gravis Symptoms

Work with your doctor to learn how to best manage MG symptoms. Exercise regularly, but don’t push yourself past your limits. Eat well and take rest breaks when you need them.

Most people with MG have periods of symptom remission. The condition is treatable, with medicines that filter out abnormal antibodies or add healthy ones to your blood.

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The most common symptom of Myasthenia Gravis is muscle weakness. You may have trouble getting out of a chair or climbing stairs. You may also find it hard to chew or swallow. Sometimes your muscles tire quickly, which can cause you to choke or slur your words. This symptom can affect the muscles in your arms, legs or face. You may have trouble holding up your head (dropped head syndrome).

Muscle weakness is caused when brain impulses don’t reach muscles as easily as usual. With MG, antibodies destroy the receptor sites on muscle tissue that normally catch nerve signals, so communication between the two is blocked.

This symptom can be worsened by stress, certain medications or infections. It can lead to a myasthenic crisis, in which your breathing muscles weaken and you need emergency treatment. Surgical removal of the thymus gland — a procedure called thymectomy — can reduce symptoms and restore muscle strength.

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Swallowing is a complex process that requires cooperation of about 50 pairs of muscles. If the muscles weaken due to MG, it can be difficult to chew or swallow food and fluids. This is called dysphagia.

In severe cases, the weakness can also affect the muscles that support breathing. This can cause a life-threatening complication called a myasthenia gravis crisis, in which the respiratory muscles fail and the person needs to breathe with a machine. It can be triggered by infections, extreme physical or emotional stress, certain medications (aminoglycosides, fluoroquinolones and beta-blockers) or worsening of chronic medical illnesses.

Symptoms of myasthenia gravis vary and often look like those of other conditions, so they may be misdiagnosed or undertreated. Patients should report any new symptoms to their doctor and keep track of when they occur, how long they last and what makes them better or worse.

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Difficulty breathing is a common symptom of myasthenia gravis. It can be a life-threatening problem (called myasthenic crisis) that needs to be treated in the hospital. It happens when muscles that control breathing weaken. They may be weak in the chest wall and the muscle that separates the lungs from the abdomen (diaphragm). They can also be weak in the neck and limb muscles. This weakness can make it hard to breathe and swallow. It can also cause problems with walking upstairs or raising your arms above your head.

Muscle weakness gets worse when you use the affected muscles and improves with rest. The weakness can happen in any muscle group, but it affects certain groups more often. These include the eyelids, throat, neck, and arm and leg muscles. Other symptoms of myasthenia gravis include drooping eyelids (ptosis), double vision that improves or resolves when one eye is closed, and difficulty speaking because your voice sounds soft or nasal.

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Drooping eyelids (ptosis) is a common early symptom of Myasthenia Gravis. It usually appears when the muscle in your upper eyelid gets weaker. Ptosis can make your eyes appear tired and may cause double vision. It can also affect your ability to read and drive a car.

MG causes weakness in many different parts of the body, but smaller muscles usually start to show symptoms first and larger muscles become weaker as the disease progresses. About 85% of patients who initially have ocular MG will develop systemic MG within three years.

Doctors diagnose MG by asking about your symptoms and doing a physical examination. They may perform a test called the edrophonium test, which involves placing edrophonium drops on your eyelid and measuring your response. They might also order a blood test to look for antibodies that interfere with the receptor sites where nerve impulses send signals to muscles. They might also order a procedure called plasmapheresis or intravenous immunoglobulin, which help eliminate the antibodies in your body.

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The muscles that control the eyes and eyelids are weak in 15% to 50% of people with myasthenia gravis. This form of the disorder is called ocular myasthenia gravis. People with this type of myasthenia have trouble coordinating their eye movements, resulting in double vision. They might also have drooping of the upper eyelids, or ptosis. Some people with ocular myasthenia gravis develop generalized myasthenia gravis, in which their weakness spreads to other muscles.

Early MG symptoms, like double vision or drooping eyelids, come on gradually and get worse over weeks or months. Because of this, many people don’t seek treatment until the problem gets worse.

To diagnose ocular myasthenia gravis, a doctor may do a series of tests to see how the muscles work. They might ask the person to look up at a ceiling for a time, check for the Cogan lid twitch sign (the upper eyelid moves into an exaggerated position and then slowly drifts back into place) or perform a forced-eyelid closure test. Doctors might also order blood tests to check for autoantibodies that are associated with MG.

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If you find that your speech becomes more difficult over time, this can be a symptom of myasthenia gravis. It might also be caused by the medicines you take. If you have myasthenia gravis, you should always tell your healthcare providers about any medicines you take so that they can check whether they interfere with your disease or its treatment.

If your speech sounds slurred, harsh, breathy or nasal and seems to become slower over time, you may have dysarthria. Dysarthria is caused by nerve and brain disorders that affect your muscles.

Spastic dysarthria is a result of damage to the upper neurons on one or both sides of your brain. Ataxic dysarthria is caused by damage to the part of your brain called the cerebellum, which helps coordinate movement. Hypokinetic dysarthria is a slow (“hypo”) and monotone-sounding form of the disorder. It’s associated with problems with the movements of your mouth, tongue and face.