What is the Treatment for Myasthenia Gravis?

Myasthenia gravis is characterized by erratic weakness in muscles and affects mainly eyes, throat, hands, and legs. It can also affect the muscles of the respiratory system causing an emergency. Myasthenia gravis is an autoimmune disorder and is a disease of skeletal muscle where the neuromuscular junction is affected. In this disease autoantibodies are formed against the body's own specific protein found in the neuromuscular junction, which is responsible for electrical signal transmission. The reduced transmission of signals across the neuromuscular junction of a particular organ causes muscle weakness. Myasthenia gravis treatment provides symptomatic relief and enhances the quality of life of the patient.  

Treatment of Myasthenia Gravis

Myasthenia gravis generally occurs in genetically susceptible people and this disease is known to be precipitated by factors like infections, vaccination, surgery, emotional stress, etc. The symptoms of the disorder include muscle weakness around eyes, mouth, other regions of face, and limb muscle weaknesses. Treatment of myasthenia gravis is done mainly through immunosuppressive agents and acetylcholinesterase enzyme inhibitors.  

The following treatment options are recommended for myasthenia gravis: 

• Acetylcholinesterase enzyme inhibitors: As this disease is associated with reduced communication between nerves and muscles, medicines are given to improve the communication between them. Acetylcholinesterase inhibitor increases the level of acetylcholine at neuromuscular junction which further enhances the communication. Pyridostigmine bromide is given to the patient  as it has a longer duration of action and results in symptomatic relief in myasthenia gravis patients. 
• Immunosuppressive medicines: Immunosuppressive medicines are usually recommended in cases when there is no symptomatic improvement after Pyridostigmine bromide treatment. The first line immunosuppressive agents used for the treatment of myasthenia gravis patients are glucocorticoids and azathioprine. Glucocorticoids like prednisone, prednisolone, and methylprednisolone are recommended to the patients which results in symptomatic improvement. If there is any problem experienced or there is no improvement in patient’s condition then the second line immunosuppressive agents are provided such as methotrexate, mycophenolate, cyclosporine, cyclophosphamide, and tacrolimus.
• Plasmapheresis:This therapy is recommended either in case when the immunosuppressive agents did not work or when there is need to stabilize patients before operative procedures as in myasthenia crisis i.e. myasthenia gravis affecting the respiratory system muscles. Here intravenous immunoglobulins are injected in patients.
• Thymectomy: This is recommended only in case of patients with thymoma where cancer is formed in and around the thymus gland. In myasthenia gravis patients with thymoma, thymectomy is recommended. 

The main feature of myasthenia gravis patients is the intermittent muscle weakness in the affected body part. The muscle weaknesses particularly worsen with excess physical activities and improve with rest. Myasthenia gravis usually get aggravated due to various factors and it is important to identify the symptoms as early as possible. The myasthenia gravis treatment should be given at the right time to decrease the aggravation and control the symptoms. These treatments are usually expensive and can cause extra economic burden. Thus having a good health insurance policy creates a safety net to fall back on in times of distress.