What to do about myasthenia gravis

  Myasthenia gravis (MG) is a chronic autoimmune disease caused by dysfunction in the transmission between nerve and muscle junctions. The disease has a tendency to remit and relapse, and can occur at any age, but mostly in children and adolescents, with more women than men, and more men in later life. This weakness is reversible and can be recovered with rest or anticholinesterase medication, but is prone to recurrence.  The pathogenesis of myasthenia gravis is composed of the postsynaptic muscle cell membrane and the synaptic gap between them. When a motor command is transmitted down the presynaptic motor nerve endings, it activates; the pathogenesis of myasthenia gravis is the release of the chemical transmitter acetylcholine from the synaptic vesicles to the synaptic gap, and acetylcholine moves through the gap to the postsynaptic myocyte membrane post-synaptic myocyte membrane will be with the above. Patients with myasthenia gravis generally vary greatly in the extent and degree of muscle groups involved, but the secondary eye muscles are most involved, accounting for more than 90%, followed by the medulla oblongata, and then the cervical muscles, shoulder girdle muscles, upper limb muscles, trunk muscles and lower limb muscles are involved or the whole body muscles are involved at the same time.  Myasthenia gravis, known as “myasthenia gravis” in mainland China, is a disease of the nerve muscles that causes muscle tremors, weakness and easy fatigue. Myasthenia gravis is a disorder of the autoimmune system that prevents the circulation of antibodies and blocks the junctions of acetylcholine receptors in the postsynaptic neuromuscular junction. The main clinical feature of myasthenia gravis is local or generalized fatigue and weakness of the transverse muscles during activity, which can be relieved by rest or anticholinesterase drugs. Myocardial and smooth muscles may also be involved, showing the corresponding visceral symptoms.  Myasthenia gravis commonly includes ocular muscle weakness, medullary muscle weakness, generalized muscle weakness, simple spinal muscle type, and myasthenia gravis crisis.  Ophthalmic muscle weakness: It manifests as drooping eyelids and eye movement disorders on one or both sides, or alternately on the left and right. About 1/4 of the patients can recover spontaneously, but the adult onset of extraocular muscle weakness often evolves into generalized muscle weakness in one to several years.  Myelomeningeal muscle weakness: This is characterized by weakness of the facial expression muscles, weak eyelid closure, slurred speech, and easy fatigue. The myasthenia gravis may involve other skeletal muscle groups throughout the body and may be triggered by upper respiratory tract infections.  Systemic myasthenia gravis: The symptoms of myasthenia gravis are manifested by the simultaneous involvement of extraocular muscles, facial expression muscles, medullary muscles, cervical muscles, masticatory muscles and limb muscles. These symptoms can develop gradually from weakness of the eye muscles alone or the medulla oblongata muscles, or from weakness of several groups of muscles at the same time.  Pure spinal muscle type: It is characterized by extreme weakness of the proximal muscles of the extremities, difficulty in going upstairs and easy to fall, etc. The effect is good after rest or anticholinesterase drug treatment. Most patients rapidly evolve into generalized muscle weakness several months to years after the onset of muscle weakness in the extremities.  Myasthenia gravis is a life-threatening condition called myasthenia gravis when patients with myasthenia gravis have difficulty swallowing and breathing, which affects their lives. If not corrected in time, it can be life-threatening due to respiratory failure, and multiple crises can occur in one patient, with a high mortality rate.