Treatment for myasthenia gravis can significantly improve symptoms ofmuscle weakness and many people with the conditionare able to lead a relatively normal life. However, severe or chronic symptoms frequently require long-term treatment.
If symptoms aremild, many people find that getting plenty of rest helps improve their symptoms without the need for additional treatment.
Medicines such as pyridostigmine ,an acetylcholinesterase inhibitor, prevent the breakdown of acetylcholine, an important chemical thathelps themuscles contract (tighten).
These medicines tend to work best in mild myasthenia gravis. They can improve muscle contractions and strength in affected muscles.They're often usedif the initial symptoms aren't too severe but pyridostigmine isn't a suitablelong-term treatment for most people.
However, they can cause side effects, such as stomach cramps, muscle twitching, Traveller's diarrhoea and nausea. Other medications may be prescribed to counteract these side effects.
If initial treatment withpyridostigmine isn't effective, or only suitable for temporary use, then steroid tablets, such as prednisolone, are used at a low dose. The dose can be increased gradually over time and is usually kept at a high dose for several months until remission is achieved.
Immunosuppressant medication may be prescribed if remission isn't achieved or the high dose of prednisolone isn't suitable. This is usually azathioprine , mycophenolate ormethotrexate. These are used to help achieve remission so the prednisolone dose can be reduced and eventually stopped.
Your blood will have to be regularly monitored when taking immunosuppressants, which may take at least a year to take full effect.
If long-term remission is achieved over time (usually years), it may be possible to stop all immunosuppressant medication.
In some cases ofmyasthenia gravis, surgery to remove the thymus gland (a thymectomy) may be recommended.
In some studies, thymectomy has been shownto improve the symptoms of people who don't have tumours (thymomas) on their thymus gland.The improvement often happens within the first few months, although continued benefit may be seen for up to two years after surgery. Nowadays, the thymus gland is usually removed using keyhole surgery.
The current recommendations for people under 45 years old, with general symptoms of myasthenia gravis, no thymomasand have had the illness for less than two years, thymectomy gives:
A thymectomy often has little effect on the symptoms of myasthenia gravis for people with thymomas. However, removal is often recommended to avoid complications caused by the tumour spreading in the chest.
Plasmapheresis or intravenous immunoglobulin therapy may be needed in very severe cases of myasthenia gravis, where a person's muscle weakness is causing life-threatening breathing or swallowing problems.
These treatments are given in hospital and involve:
Both treatments can improve the symptoms of myasthenia gravis , but the benefits usually only last a few weeks. They aren't suitable as long-term treatments for myasthenia gravis, and are usually only used to treat people who are seriously ill.
Myaware is a UK registered charity that provides additional useful information about living with myasthenia gravis.
The charity also has Facebook groups, which provide valuable support.
Myasthenia gravis is a rare long-term condition that causes certain muscles in the body to become weak.
Muscle weakness is the main symptom of myasthenia gravis. The eye and facial muscles and those that control swallowing are commonly affected.
Myasthenia gravis is caused by a problem with the transmission of nerve signals to the muscles.
Confirming a diagnosis of myasthenia gravis can take a long time because the condition is rare and muscle weakness is a symptom of many different conditions.
There is no cure for myasthenia gravis, but treatments are available to help control the symptoms.