Myasthenia gravis is a complicated and frightening autoimmune condition where the body’s defences attack the immune system. The effect is that it primarily impacts the neuromuscular system, resulting in muscle weakness throughout the body. In most cases, this will manifest with drooping eyelids, a slack jaw, and the inability to control your neck, limbs, and other muscles.
Unfortunately, as with many autoimmune conditions, there is no cure for myasthenia gravis, and it is a lifelong condition. However, there are treatments available that can mitigate symptoms and allow people with the condition to live a long and mostly normal life. To receive these benefits, it is important to have myasthenia gravis diagnosed as early as possible so that you can start your treatment plan.
Currently, medications are the primary treatment for myasthenia gravis and the symptoms it causes. Here are the three main types of medications that get utilized.
Cholinesterase inhibitors, specifically pyridostigmine, are the main medication used to treat myasthenia gravis. Cholinesterase inhibitors work by suppressing cholinesterase, which can block signals that are sent from the brain to various muscles. By blocking cholinesterase, nerve signals are able to travel uninhibited and can prevent drooping and weakness. The downside of cholinesterase inhibitors is that they do not last very long, and it is a multi-daily medication.
Certain corticosteroids, such as prednisone and budesonide, impede the ability of the immune system to produce antibodies. As a result, it does not attack itself quite as aggressively, which leads to less muscle weakness and drooping.
As an autoimmune condition, immunosuppressants are used to suppress the immune system to keep it from attacking itself. Cyclosporine and tacrolimus are two of the main immunosuppressants used in the treatment of myasthenia gravis.
In cases where medications are not doing the trick, you may need to undergo a thymectomy. During this operation, your thymus gland is removed, as it is responsible for creating defensive T-cells. With its removal, your immune system is less prone to attacking itself, and it is one of the most effective but invasive treatments for myasthenia gravis.
In addition to surgery and medications, there are also several IV therapies that can treat myasthenia gravis.
As the name implies, plasma exchange is a treatment where you are hooked up to a machine similar to a dialysis machine. Also known as plasmapheresis, this treatment is where bad antibodies are removed from the body and replaced with healthy ones.
Another option that uses natural antibodies rather than bioengineered ones is to receive IV immunoglobulin therapy. You receive these antibodies from a matched donor, and it is an effective treatment for myasthenia gravis as well as when your body is in crisis, which is a rapid onset of symptoms.
During a monoclonal antibody IV treatment, you have a steady stream of monoclonal proteins pumped into your system. Like corticosteroids, monoclonal proteins can block your immune system and keep it from attacking itself. However, because this treatment can cause serious side effects, including fever, nausea, low blood pressure, weakness, and more, it is reserved for extreme situations.
In some instances, myasthenia gravis can attack quickly and with powerful symptoms. If this happens, it is important to go to an emergency medical centre for more comprehensive treatment and interventions. However, this often happens with people who do not know they have myasthenia gravis. Once you are aware of your condition, the treatments above are usually enough to protect you.