The main symptoms, causes and treatment of myasthenia gravis
A Disease characterized by abnormal fatigue of muscles, called myasthenia gravis, symptoms, causes of disease are linked with autoimmune processes.
This disease is recorded is not so rare, 100 thousand people approximately 5-10 cases. Among patients most women. The patients ' age from 15 years to 45, but most of them are patients aged 20-30 years.
the International classification of diseases the disease has its own code – ICD 10 G70.2.
General information about pathology
Myasthenia Gravis relates to special illnesses. It is characterized by the fact that weakening of striated muscles. This condition is intensified during exercise. Cost to the patient to relax, weakness reduced.
The Disease is autoimmune. Treated with hormonal drugs.
Interesting fact – the disease affects not only the person. And at-risk Pets: cats and dogs.
Myasthenia Gravis is divided into 3 types:
- bulbar myasthenia gravis – characterized by impairments in chewing and swallowing, over time, the patient's speech loses the sound;
- ocular myasthenia gravis – if you suffer her neck muscles and cranial, drooping of the eyelid is the main symptom of this form of disease;
- generalized myasthenia gravis – the most common form of the disease is manifested lesions of the facial and neck muscles, gradually spread to all other muscles.
just to answer the question of what are the causes of disease, nobody can. It is believed that heredity plays a role in the development of the disease. If the diagnosis of the doctor interrogates the patient, and often it turns out that among the relatives surveyed are those who suffer or who suffered from myasthenia gravis.
This disease often occurs not by itself but in conjunction with neoplasms of the thymus gland, cancer and amyotrophic syndrome, diseases of the connective tissue.
Myasthenia is congenital and acquired. The acquired form is much more common than congenital. It occurs at any age. The reasons for the development are various infections and genetics. Affects eye muscles and muscles of the entire body. Congenital myasthenia is rarely diagnosed. An illness of a child begins at the moment when the fetus is in the womb. He gets it by inheritance from his mother. During examination of the fetus, there has been little activity. And once the child is born, the doctor sees that he is very weak and not even able to breathe. This is due to the complete atrophy of muscles, including respiratory. These children die shortly after birth. But there are also happier occasions: when professional therapy myasthenia gravis can and retreat.
How to manifest the disease?
Muscle weakness, significant fatigue, which manifests itself always in this disease. The patient feels that the muscles get tired to the point that disobey his master. After resting, the health is restored. In the morning, after waking, the patient feels well, and after a few hours the symptoms of myasthenia accrue.
Doctors say that the disease is often diagnosed when it quite running. Therefore, you should pay attention to any signs of possible pathology:
- during the conversation, the patient suffers voice fading
- when eating ill difficult to chew and swallow;
- the patient is too tired quickly, and his eyelids lowered.
You Can do this test to detect hidden disease:
- on request to open and close your mouth within 40 seconds, a healthy person will perform more than 100 movements, while the patient will not be able to do half of it;
- ill will involuntarily lowered eyelids, if you ask it to compress and unclench fingers of hands at a rapid pace;
- patient will not be able minute to keep the head elevated, lying on your back;
- 20 sit-UPS for him would be an insurmountable problem.
If the local gravis, weakness occurs in any one muscle group. In a generalized form not properly work all the muscles.The ocular form of the disease characterized by strabismus. Perhaps a split eye. The patient won't be able to look at an object, it becomes impossible to focus. Patients have one common symptom – lowered upper eyelid. This only happens in the evenings.
Bulbar form is characterized by pathology in the muscles of the face and masticatory muscles. Previously, the usual conversation is so tiring man, it would take one hour of rest to recuperate. Chewing for the patient becomes a formidable obstacle. Soeating is transferred to the first half of the day, in the evening as ill.
Generalized myasthenia occurs gradually. This is the most dangerous form of the disease. The defeat of the oculomotor muscles is replaced by the pathology of the neck muscles, hands and feet. The patient can not hold his head up, watch out for the saliva. There are problems with movement, getting weak respiratory muscles. All this can lead to a fatal outcome.
How the disease diagnosed?
Diagnosis of myasthenia gravis is performed by several methods. It all starts with the clinical examination where the doctor listens to patient's complaints, examines his family history, conducts visual inspection. Putting the initial diagnosis, the doctor will direct the patient to additional tests, which can confirm the presence of the disease or deny it. This is a sample for fatigue and pharmacological, the presence of antibodies, electromyography, CT and MRI.
Test for muscle fatigue is performed by the load on them. Weakness of the leg muscles revealed by walking on the toes. The muscles of the forearm check a clenching-unclamping of the fingers. That is, certain actions show the weakness of individual muscle groups. And when talking with the patient the doctor will be able to detect impaired speech and a nasal voice.
Pharmacological tests are conducted by medications administered to the patient. They need to improve the condition of muscles. If the dynamics of symptoms thereafter, the positive, the diagnosis is confirmed. Symptoms appear in less than half an hour after the injection, but after a couple of hours back.
because myasthenia is an autoimmune diseases, diagnosis is carried out and the identification of antibodies to acetylcholine receptors.
Of the 10 patients they found 9. If antibodies are found, the disease is confirmed.Electromyography studies the action of certain muscles. If you register their fatigue, the diagnosis is confirmed.Computed tomography and magnetic resonance, explores the comorbidities, for example, the thymus. The doctor sees the body and diagnose a tumor, if present.
Tactics and methods of treatment
Treatment of myasthenia has 2 aims: to improve the performance of the muscles by transmitting to them the nerve impulse and to suppress the autoimmune process.
In the first case, applicable treatment medications anticholinesterase action (neostigmine, oksazil, pyridostigmine). The dose steals up strictly individually for each patient, taking into account all possible contraindications. To minimize possible side effects help medications prescribed doctor: veroshpiron, ephedrine and others.
To Suppress the autoimmune process help glucocorticoids (prednisone, dexamethasone, and others). To achieve the expected results dose decreases from curative to supportive. But the drug is not completely overturned. If you stop taking it, the disease will return.
If a positive result or not glucocorticoids are contraindicated for the patient, appointed immunosuppressants. Patients with tumor of the thymus is recommended a surgical treatment that removes part of the thymus gland completely. After surgery, radiotherapy is performed.
Another method of treatment is plasmapheresis, the plasma is cleared of antibodies. If there comes a crisis of myasthenia gravis with respiratory failure, patients underwent tracheostomy and was transferred on artificial lung ventilation. Food with myasthenic crisis is through a tube – a tube that passes through the nose and stomach.
Further, the prognosis is favorable in cases where the patient was given correct treatment. It is also important that the compliance of patients taking medicines. But the aggravation of the ailment is possible at any time. And myasthenic crises often end with fatal outcome.
Advice of folk healers
At home the patient can help themselves by applying some folk remedy:
- Improves the condition of the dried apricots, honey, onion, garlic and other foods that contain a lot of potassium.
- you Can prepare an infusion of oats with water at the rate of half a liter of water and a Cup of oats. Steamed the mixture on low heat for about an hour. Within a half hour to insist. Half a Cup of broth with a spoon of honey to take 4 times a day before meals. The course lasts 3 months and then have a month break. Conducted 2 courses.
- Sugar and onion (200 grams of each ingredient) pour half a liter of water. Boil for half an hour, cool, put in the prepared solution of 4 tablespoons of honey. Take 20 ml 3 times a day.
The Patient should pay attention to sufficient physical activity. Should stop intake of alcohol and nicotine. To get rid of life stress, nervous strain. Can't be for a long time under the sun. Prohibited drugs are magnesium, various antibiotics, diuretics. You need to consult with the doctor before to take any new medicines.
The doctor Usually recommends the patient undergo a course of sanatorium-resort treatment. But a hospital need to choose not in the South, under the scorching rays of the sun, and in the middle lane. Thanks to modern medicines deaths from this disease are very rare.
As a preventive means, it is recommended maintaining a healthy lifestyle, diet, physical activity, stress and lack of time has not cured the disease.
Can I sick women to plan pregnancy
Many women of reproductive age are interested in the question of how to combine gravis and pregnancy. This question cannot be answered unequivocally. Much depends on the existence of the disease and the characteristics of the organism. A woman cannot make this decision independently. Mandatory consultation of the attending physician, gynecologist, endocrinologist.
If the patient is registered with a doctor, the disease occurs medication is chosen, the doctor will not be against what the woman wanted to become a mother.There may be difficulties in childbirth, since these patients are usually labors of the weak. But in the hospital in advance to prepare and plan the tactics of delivery.
A fifth of the patients women a baby is born with myasthenia. The reason is that antibodies from the mother enter the fetus through the placenta. With a professional treatment all the symptoms of the disease, the infant will be held.
Intricate is the situation, when a healthy woman becomes pregnant, and the male occurred in this period. This is a rare occurrence, but it occurs. If the disease takes a severe course, it is assigned to serious drugs to save the life of the patient. But on the fetus, they act negatively. Possible mutation or spontaneous abortion. Doctors usually advise to perform the abortion.