Q: My sister-in-law was diagnosed with myasthenia gravis. What is this disease and what can be done to combat it? — L.F., Macon
A: Myasthenia gravis is a chronic, auto-immune disease where the person’s body inappropriately attacks the nerve-muscle junctions as though they were foreign invading tissues, leading to an abnormal weakness of voluntary muscles.
The weakness in myasthenia gravis improves with rest and worsens with activity.
The muscles of the eyelids and eye itself are generally affected earliest in the disease course. Weakness occurs when the nerve impulse does not adequately reach the muscle cells. Eyelid droop and double-vision often result.
Other muscles that may be affected include those of the neck, arms, shoulders, hip muscles, diaphragm and legs.
Myasthenia gravis occurs in all races, in both sexes and at any age. It affects roughly three of every 10,000 people. There’s no way to prevent its occurrence.
Although there’s no cure, there are treatments to combat muscle weakness and fatigue. Mestinon is the most widely used drug. It blocks the ability of the enzyme that breaks down the nerve-chemical transmitter acetylcholine. Immune system suppressing drugs like prednisone or azothiaprine also have been used with fairly good success. During severe flares of myasthenia gravis, plasmaphoresis to filter the blood of abnormal antibodies can result in a striking, if only short-lived improvement in symptoms. Sometimes, folks will go into remission, with disappearance of symptoms.
Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.