Dr. M.J. Bazos,
Patient Handout
MYASTHENIA
GRAVIS
About Your
Diagnosis
Myasthenia gravis is a
disease of the central nervous system that affects individuals of any age or
ethnic group. It is characterized by sporadic muscular fatigue and weakness,
occurring chiefly in the muscles of swallowing and chewing as well as the
muscles of the eyes, face, and neck. The exact cause of myasthenia gravis not
well understood, although it is believed to be a defect where the nerve meets
the muscle. Also, the muscles of the arms and legs may become weak or easily
fatigued. One of the first symptoms that
many
patients notice is double or blurred
vision, and/or drooping of the eyelids. The muscles that control breathing may
also be affected, which may result in shortness of breath. The symptoms of
myasthenia gravis may get better (remission) for a period, then may worsen
(exacerbation) for a period. The amount of time between remission and
exacerbation is unpredictable. Unlike other disorders of the central nervous
system, the progression of myasthenia gravis is exceedingly slow. Myasthenia
gravis is diagnosed by obtaining a medical history, performing a physical
examination, and administering the “tensilon test.” This test is
performed in the hospital. The medication (tensilon) is injected through an
intravenous line, and the physician observes the effect of the medication on the
symptoms. The test usually takes about 30 minutes, but the patient is often
observed for an hour or longer. Your physician will discuss the risks and
benefits of this test with you. You may also need a computed tomography (CT)
scan of your neck and upper chest to look for enlargement of the thymus
gland.
Living With Your
Diagnosis
Myasthenia gravis may affect
your vision. If you are having double or blurred vision, you should avoid
driving or operating heavy equipment and you should consult your eye doctor.
There may be times when your ability to swallow will be affected. During those
times, try foods of different consistency to determine what is easiest. Often
thin liquids such as juice and water are more difficult to swallow than thick
liquids. If you take medications regularly, ask your physician about liquid
formulations instead of tablets. One of the most frightening symptoms of
myasthenia gravis is shortness of breath. This may occur at any time and may
require medical attention. Your physician may request a test called a pulmonary
function test. This is an office test that measures how well your lungs are
working. It is usually done during a remission phase to determine a baseline so
that testing during an exacerbation can be compared. If you have had shortness
of breath, it is best to avoid smoke and dust. Wear a medic-alert bracelet or
necklace in the event you have a sudden attack and need to be taken to a
hospital. Fatigue is a common symptom of myasthenia gravis so get plenty of
rest. You may need brief rest periods during the day (about 10–15
minutes). Avoid strenuous work that may increase fatigue. If you have a
stressful job, learn ways to manage stress more effectively. Often, employers or
local schools offer seminars on stress management. A regular exercise program
will also help with stress management, but check with your physician before
beginning any exercise program.
Treatment
A
short hospital stay is recommended to perform the necessary tests for diagnosis.
Once the diagnosis is confirmed, treatment should begin. The goal of therapy is
to treat the symptoms and to induce a period of remission. The most common
medications used to treat myasthenia gravis are steroids and anticholinesterase
medications (e.g., Mestinon). Your physician will discuss the medications and
regimen best for you. Try to maintain a daily exercise program as advised by
your physician and physical therapist. They will teach you the proper exercises
to strengthen and tone your muscles.
The
DOs
• Get plenty of
rest.
• Wear a medic-alert bracelet
or necklace at all times that has “myasthenia gravis” engraved on
it.
• Take your medications as
prescribed.
The
DON’Ts
• Don’t use
tobacco because it may worsen your shortness of
breath.
•Avoid smoke (woodstoves,
campfires).
•Avoid situations that
may cause or aggravate allergies (pets, pollen, and
dust).
When to Call Your
Doctor
• If you have shortness of
breath.
• If your symptoms worsen to
include double vision, blurred vision, or
weakness.
• If you have any problems
associated with your medications.