Myasthenia - autoimmune disease with exercise-induced muscle weakness
Myasthenia is an autoimmune disease with muscle weakness that worsens over the course of the day. Find out more about the causes, diagnosis and modern therapies.
Things worth knowing about "Myasthenia"
Myasthenia, also known as myasthenia gravis, is a chronic autoimmune disease in which the transmission of signals between nerves and muscles is disturbed.
The immune system forms antibodies against acetylcholine receptors (AChR) or the enzyme MuSK, which means that the stimulus at the transition from the nerve to the muscle is only passed on to a limited extent. The result is a load-dependent, often fluctuating muscle weakness, which usually worsens during the course of the day. The disease often begins insidiously and first manifests itself in the eye muscles, for example through drooping eyelids (ptosis) or double vision (diplopia). Later, swallowing and speech disorders, powerlessness in the arms and legs or even difficulty breathing can occur - in severe cases, a myasthenic crisis occurs, which requires intensive medical treatment.The symptoms vary greatly and many patients experience phases of improvement and relapses.
Diagnosis is based on the detection of specific autoantibodies, neurophysiological tests such as EMG and imaging to assess the thymus, as a thymoma is often present. Treatment is individualised and comprises several pillars:
- acetylcholinesterase inhibitors such as pyridostigmine to improve signal transmission
- immunosuppressants (e.g. B. azathioprine or cortisone) to regulate the autoimmune reaction
- plasmapheresis or intravenous immunoglobulins (IVIG) for acute crises
- Thymectomy, i.e. surgical removal of the thymus, for pathological changes
With individually tailored therapy, many sufferers can lead a stable and active life for years. What is important is early diagnosis, regular check-ups and a holistic therapeutic approach that also takes psychological stress into account.
References
- Gilhus, N. E. (2016). ""Myasthenia gravis."" New England Journal of Medicine.
- Meriggioli, M. N. & Sanders, D. B. (2009). ""Autoimmune myasthenia gravis."" The Lancet Neurology.
- Howard, J. F. et al. (2012). ""Therapy of autoimmune myasthenia gravis."" Neurologic Clinics.
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