Myasthenia Gravis

Myasthenia gravis (MG) is an autoimmune condition that affects how your nerves and muscles communicate. It can make you feel weak, and your muscles can get tired quickly. It’s a lifelong illness but treatment can help you manage your symptoms and live well.

At Banner Brain & Spine, our neurology specialists understand how myasthenia gravis affects your life. Our expert diagnosis, advanced treatments and long-term support can help improve your strength, health and wellbeing.

What is myasthenia gravis?

Myasthenia gravis is a condition where your immune system mistakenly attacks the place where nerve signals connect to your muscles, called the neuromuscular junction. This disruption means your muscles don’t get as many nerve signals, so they become weaker.

MG typically affects the muscles in your eyes and your vision at first. In some people, as it gets worse it affects the face, neck, arms, diaphragm (one of the muscles used for breathing) and legs, which means it can impact your ability to speak, chew, swallow, breathe and move.

What are the symptoms of myasthenia gravis?

Myasthenia gravis symptoms may come and go and often get worse after you’re active and improve after you rest. Symptoms often get worse in the first one to three years, then stabilize. You will generally feel strongest at the beginning of the day and weaker by the end.

Common symptoms include:

• Eye muscle issues such as drooping eyelids (ptosis) or double vision or blurry vision (eye symptoms are often the first sign of myasthenia gravis)
• Muscle weakness in your arms and neck, which can make it hard to lift objects overhead and to keep your head raised up
• Muscle weakness in your legs, which can make it difficult to stand up from a chair or couch             
• Fatigue, even after small movements
• Face and throat muscle difficulties, which can make it hard to speak, swallow, eat or smile
• Shortness of breath, which can make it feel more like you’re exercising even though you’re just sitting down     
• A more severe breathing issue, called a myasthenic crisis, can be life threatening

What causes myasthenia gravis?

An abnormal immune system response causes myasthenia gravis. Your body creates antibodies that block or damage receptors that carry messages from your nerves to your muscles. Without those messages, your muscles can’t work the way they should.

Researchers believe that thymus gland growths or tumors may be linked to MG. In some people with myasthenia gravis, the thymus gland is larger than usual. About one in ten people with myasthenia gravis also have thymomas (thymus gland tumors). These tumors are usually slow-growing and may or may not be cancerous.

Anyone can get MG, but it’s more common in women under 40 and men over 60. You may be at a higher risk if you have other autoimmune conditions, such as rheumatoid arthritis or lupus.

A rare form called neonatal myasthenia can happen in newborns if the mother has the condition. This type usually goes away in a few weeks. 

How is myasthenia gravis diagnosed?

At Banner Brain & Spine, our neurologists review your symptoms and medical history and perform a physical exam. Early diagnosis is important so you can start treatment as soon as possible and help avoid complications.

Diagnostic tests may include:

• Neurological exam to test your reflexes, muscle strength, muscle tone, senses of touch and sight, coordination and balance
• Blood test to check for antibodies that interfere with nerve-muscle communication
• Nerve conduction studies (NCS) with electrodes to see how well the nerve can send signals to the muscle
• Electromyography (EMG) to measure electrical activity in your muscles
• CT scan or MRI to check for tumors or other issues with your thymus gland
• Pulmonary function tests to check for breathing issues

How is myasthenia gravis treated?

There is no cure for myasthenia gravis, but it’s treatable and many people with it can live full and active lives. 

At Banner Brain & Spine, we offer effective treatments to help you manage your symptoms and improve the way your muscles work. We create a personalized care plan based on your age, how severe the disease is and how quickly it is getting worse.

Medication

• Cholinesterase inhibitors may help your nerves and muscles communicate
• Corticosteroids may help keep your immune system from producing abnormal antibodies 
• Immunosuppressants may help reduce immune attacks

Intravenous therapy

IV therapy may be used to treat symptoms that get worse quickly:

• Plasmapheresis (plasma exchange) filters your blood to help remove harmful antibodies 
• Intravenous immunoglobulin (IVIg) adds antibodies to your body to help change your immune system response
• Newer treatments such as monoclonal antibodies help reduce symptoms

Some of these treatments may also be offered subcutaneously (under the skin).

Surgery

Removing the thymus gland may improve your symptoms. If you have a tumor in your thymus gland, you’ll need to have it removed surgically.

Physical therapy

Physical therapy can help you stay active and improve the way your muscles work.

You’ll need ongoing follow-up care to adjust your treatment as needed and watch for flare-ups.

How can you manage myasthenia gravis?

To live with myasthenia gravis you’ll need to learn how to manage your symptoms and energy levels. Your care team can help you build a healthy daily routine and avoid things that trigger symptoms.

These lifestyle adjustments may help:

• Adjust your eating routine: Try to eat when your muscle strength is good. Take your time chewing your food and take breaks between bites. You might find it easier to eat small meals several times a day. 
• Conserve energy: Take naps or rest breaks throughout the day. Tackle your most exhausting tasks earlier in the day when you feel your strongest.
• Exercise regularly: Gentle physical activity can help maintain your conditioning, improve your mood and give you more energy. Talk to your health care provider before starting any exercise program.
• Use safety precautions: Install grab bars or railings near the bathtub or steps. Keep your floors clean and remove area rugs. Have leaves and snow cleared from sidewalks and driveways so you don’t trip or slip.

Where can you find support and resources?

Coping with myasthenia gravis can be challenging for you and your loved ones and stress may make it worse. You can live a full life with the right care, support and planning. 

Learning all you can about your condition can be helpful. Organizations like the Myasthenia Gravis Foundation of America (MGFA) offer support groups, patient registries, educational resources and other assistance. You are not alone and support is available.

Why Choose Banner Brain & Spine for myasthenia gravis care?

At Banner Brain & Spine, we’re committed to helping you live better with MG. We provide trusted care that includes:

• Experienced neurologists 
• Advanced diagnostic tools and up-to-date treatments including infusions and surgery to remove the thymus gland
• A full care team, including neurology, rheumatology, pulmonology and surgery

If you’ve noticed vision problems, muscle weakness, fatigue or other symptoms of myasthenia gravis, don’t wait. Our experts can help you get answers and start treatment.