Myasthenia gravis is an autoimmune neuromuscular disease. A patient will have varying degrees of weakness of the skeletal (voluntary) muscles of the body. For the majority of individuals with myasthenia gravis, life expectancy is not lessened by the disorder.
The characteristic feature of myasthenia gravis is muscle weakness that increases during periods of activity and improves after rest. Certain muscles such as those that control eye and eyelid movement, facial expressions, chewing, talking, and swallowing are often, but not always, involved in the disorder. The muscles that control breathing and neck and limb movements may also be affected.
Myasthenia gravis is caused by a defect in the transmission of nerve impulses to the muscles. It occurs when there is an interruption in transmission of neurochemical impulses between the nerve and muscle, at the neuromuscular junction (the place where nerve cells connect with the muscles).
Myasthenia gravis is an autoimmune disease because the immune system – which normally protects the body from foreign organisms – mistakenly attacks the body itself.
Although myasthenia gravis usually affects muscles that control eye and eyelid movement, facial expression, and swallowing are most frequently affected. The onset of the disorder may be sudden. Symptoms often are not immediately recognized as myasthenia gravis.
In most cases, the first noticeable symptom is a weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be seen first. The degree of muscle weakness involved in myasthenia gravis varies from patient to patient, ranging from a single set of muscle involvement to a group of different muscles involvement – sometimes including those that control breathing – are affected. Symptoms, which vary in type and severity, may include a drooping of one or both eyelids (ptosis), blurred or double vision (diplopia) due to weakness of the muscles that control eye movements, unstable or waddling gait, weakness in arms, hands, fingers, legs, and neck, a change in facial expression, difficulty in swallowing and shortness of breath, and impaired speech (dysarthria).
Myasthenia, in newborn babies, may occur due to a transfer of immune proteins (antibodies) from a mother affected with myasthenia gravis. Generally, cases of neonatal myasthenia gravis are temporary and the child’s symptoms usually disappear within 2-3 months after birth. Other children develop myasthenia gravis indistinguishable from adults. Myasthenia gravis in juveniles is common.
Myasthenia gravis is not directly inherited nor is it contagious. Rarely, children may show signs of congenital myasthenia. These are not autoimmune disorders but are caused by defective genes.
Unfortunately, a delay in identifying is quite common. Because weakness is a common symptom of many other disorders, the diagnosis is often missed in people who experience mild weakness.
A special blood test can detect the presence of immune molecules or acetylcholine receptor antibodies. Most patients with myasthenia gravis have abnormally elevated levels of these antibodies. However, antibodies may not be detected in patients with only ocular forms of the disease.
Single fibre electromyography (EMG), helps in identifying a lack of transmission of impulses from nerve to the muscle. Computed tomography (CT) may be used to identify an abnormal thymus gland or the presence of a thymoma, which is another cause for myasthenia gravis.
A special examination called pulmonary function testing – which measures breathing strength – helps to predict whether respiration may fail and lead to a myasthenic crisis.
Today, myasthenia gravis can be controlled. There are several therapies available to help reduce and improve muscle weakness. But they should be taken under strict medical supervision due to some major side effects of the drugs.
Thymectomy, the surgical removal of the thymus gland (which often is abnormal in myasthenia gravis patients), reduced symptoms in more than 70 percent of patients.
Ayurvedic herbal remedies
There is no specific research done on this topic. However, Ayurveda offers many immunomodulator agents like Amrutottaram kashayam tablet. It contains Tinospora cordifolia which is a powerful immuno modulator. Rheumatoid arthritis is another autoimmune disorder, in which Amrutotaram kashayam tablet has been very effectively used.
In people having generalized muscle weakness along with myasthenia, Ashwagandhadi lehyam, can be given as an adjuvant to mainstream treatment, especially in children. It is sweet and is very easy to take. While Ashwagandha is again another powerful immunomodulator, it is also a good anti oxidant and it improves the strength of the muscles. For local application on the head, Bala Ashwagandhadi taila can be used over head, forehead and all parts of body half an hour before taking hot water bath, in the morning.