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Myasthenia Gravis Treatment

Myasthenia Gravis Treatment

Treatment for myasthenia gravis entails the use of immunosuppressive medications and surgical intervention. Read on to know all about alternative treatments for this disorder...
Dr. Sumaiya Khan
Myasthenia gravis is an autoimmune disorder wherein the body cells fail to differentiate between its own cells and foreign bodies. Thus, the body's defense cells tend to attack the body's own cells, leading to degeneration of tissues and organs. Autoimmune disease symptoms, especially myasthenia gravis symptoms are not very easy to treat, as the treatment is chalked out by a trial and error method, as the response for different treatment options vary from person to person. Given below are the various treatment alternatives for MG that are available for dealing with this condition.
Medications
One needs to understand that there is no full and final cure for myasthenia gravis. As is common with most autoimmune diseases, it is very difficult to chalk out a treatment plan that is sure to work with every patient. When it comes to its treatment guidelines, the basic protocol followed is that first all conservative treatment options are exhausted before going in for a surgical approach. Medication for myasthenia gravis consists of mainly cholinesterase inhibitors, which help to directly improve muscle function, along with other immunosuppressant drugs, that help to reduce the inflammatory immune response. Acetylcholinesterase inhibitors, like neostigmine and pyridostigmine can help to improve muscle function by slowing down the natural activity of the enzyme cholinesterase, which degrades acetylcholine in the motor end plate. Thus, the neurotransmitter is around for longer so as to stimulate the receptor. Immunosuppressive drugs like prednisone, cyclosporine may be used.
It is said that the use of steroids also helps to mitigate symptoms of myasthenia gravis. This is because even steroids suppress activity of the immune system, by preventing inflammatory changes that take place in the body and aggravate the condition. A low dose of steroids is often sufficient to deal with patients that show mild symptoms, like if it has only affected muscles around the eyes (as is seen in ocular myasthenia gravis). However, higher doses are required for cases where the symptoms affect other muscles of the body. With the help of steroids, you can slowly bring the symptoms under control, although this may take several months. Steroids in combination with immunosuppressant drugs tend to give better results.
Surgical Treatment
The other option for dealing with cases that do not respond to drugs is plasmapheresis. In plasmapheresis, the antibodies are removed from the body so that they do not attack the cells. Intravenous immunoglobulins can be used to bind to these antibodies.
Surgery is the last option for treating myasthenis gravis. In the surgery, the thymus gland is removed. The thymus gland is a small gland that is present in the upper chest just behind the sternum. The thymus gland is often abnormal in patients suffering from this disease, especially in those patients that develop the symptoms before they reach forty years of age. It is yet not clear as to how the thymus gland acts to bring about an increase in the number and activity of the antibodies against the body cells. However, this option of thymectomy is preferred when the patients show thymic abnormalities, as is seen in a thymoma. It is said that there is considerable improvement in the condition of the patient following thymectomy, as is seen in nearly 70% of the patients. Some patients even claimed that they were completely cured, with no visible symptoms of myasthenia gravis, following removal of the thymus gland.
Unfortunately, medication and surgery are the only options for dealing with this progressively degenerative disease, as there is no natural treatment. It is best to diagnose and get this condition treated at the earliest, so as to prevent the occurrence of myasthenic crisis, which is a condition that could be fatal.