Myasthenia gravis (MG) is an autoimmune condition that causes skeletal muscle weakness. These are the muscles that connect to our bones and help us move. Myasthenia gravis usually targets the muscles in our eyes, face, neck, arms and legs. It can affect our ability to:

• Move our eyes or blink.
• Keep our eyes open.
• Make facial expressions.
• Chew, swallow and talk.
• Raise our arms up and lift objects.
• Walk upstairs or get up from a chair.

Muscle weakness gets worse after physical activity and improves after rest. Symptoms usually happen quickly.

Myasthenia gravis is a chronic (long-lasting) neuromuscular condition (it affects the junction between our nerves and muscles).

Causes

Myasthenia gravis (autoimmune type) happens when our body’s immune system mistakenly attacks itself. Researchers aren’t sure why this happens. Studies suggest that certain immune system cells in our thymus gland have trouble identifying what’s a threat to our body (like bacteria or viruses) versus healthy components.

A genetic change causes congenital myasthenia. Antibodies passed from a parent to a fetus during pregnancy cause neonatal myasthenia.

How does myasthenia gravis affect my body?

Myasthenia gravis affects communication between nerves and muscles. When our immune system is working as expected, nerves and muscles work together. It’s like cricket game:

1. Nerves (the bowler) send signals to muscles (the wicket keeper) across a synapse (pitch/field) called the neuromuscular junction. To communicate, nerves release a molecule called acetylcholine (the ball).
2. Muscles have sites called acetylcholine receptors (the wicket keeper’s glove). The acetylcholine binds to its receptors in the muscle tissue, like a ball landing in a glove.
3. When the acetylcholine binds to its receptor, it triggers the muscle fiber to contract.
4. Nerves signal muscles effortlessly, like one ball player catching a ball and throwing it to a teammate.

If someone has myasthenia gravis, antibodies destroy the receptor sites, blocking nerve-muscle communication. The “wicket keeper” can’t catch the ball, and communication becomes sluggish or doesn’t work at all.

Connection between the thymus gland and myasthenia gravis people with myasthenia gravis have thymus gland conditions that may trigger symptoms. The thymus is a small organ in our upper chest. It’s part of our lymphatic system. It makes white blood cells that fight infections. Two-thirds of people with myasthenia gravis have overactive thymic cells (thymic hyperplasia). About 1 in 10 people with myasthenia gravis have thymus gland tumors called thymomas, which may be benign (not cancer) or cancerous.

Types of myasthenia gravis

The types of myasthenia gravis include:

• Autoimmune myasthenia: The most common type – it’s an autoimmune condition where the cause isn’t well understood but the likely cause is the production of certain types of antibodies (immune system proteins).
• Neonatal myasthenia: A fetus gets certain antibodies from the parent who has myasthenia gravis. An infant may have a weak cry or sucking reflex at birth. These temporary symptoms usually go away after three months.
• Congenital myasthenia: It isn’t an autoimmune condition, but a genetic change causes this type.

There are two subtypes of autoimmune myasthenia:

• Ocular: The muscles that move our eyes and eyelids weaken. Patient’s eyelids may droop, or he/she may not be able to keep his/her eyes open. Some people have double vision. Eye weakness is often the first sign of myasthenia. Ocular myasthenia gravis may evolve into the generalized form for nearly half of all people diagnosed with this type.
• Generalized: Muscle weakness affects our eye muscles and others in our face, neck, arms, legs and throat. Patient may find it difficult to speak or swallow, lift his arms over the head, stand up from a seated position, walk long distances and climb stairs.

Symptoms of myasthenia gravis may include:

• Muscle weakness in arms, hands, fingers, legs and neck.
• Fatigue.
• Droopy eyelids (ptosis).
• Blurry or double vision.
• Limited facial expressions.
• Difficulty speaking, swallowing or chewing.
• Trouble walking.

Initial symptoms of myasthenia gravis happen suddenly. Patient’s muscles usually get weaker when he/she is active. Muscle strength returns when at rest. The intensity of muscle weakness often changes from day to day. Most people feel strongest at the start of the day and weakest at the end of the day.

In rare instances, myasthenia gravis affects muscles in patient’s respiratory system. Patient may have shortness of breath or more serious breathing problems.

Risk factors for myasthenia gravis

Myasthenia gravis is most common among women and people assigned female at birth and men and people assigned male at birth. The condition can affect anyone at any age.

A person may be more at risk of developing myasthenia gravis if he/she:

• Have a history of other autoimmune conditions, such as rheumatoid arthritis and lupus.
• Have thyroid disease.

Myasthenia gravis symptoms could trigger (start) if:

• Patients take medications (allopathic) for malaria and heart (arrhythmias etc).
• Underwent surgery.
• Had an infection (any).

Complications of myasthenia gravis

Weakness and fatigue from myasthenia gravis can keep a person from participating in activities. This may lead to stress and depression.

Up to 1 in 5 people with myasthenia gravis experience a myasthenic crisis or severe respiratory muscle weakness. Patient may need a respirator or other treatments to help him breathe. This is a life-threatening medical emergency. An estimated 20% of people with myasthenia gravis experience at least one myasthenic crisis in their lifetime.

To diagnose myasthenia gravis, perform a physical exam and ask detailed questions to learn more about patient’s symptoms and medical history. Testing confirms a diagnosis. It may include:

• Blood antibody tests: About 85% of people with myasthenia gravis have unusually high levels of acetylcholine receptor antibodies in their blood. Approximately 6% of people diagnosed have muscle-specific kinase (MuSK) antibodies.
• Imaging scans: An MRI or CT scan can check for thymus gland problems like tumors.
• Electromyography (EMG): An EMG measures the electrical activity of muscles and nerves. This test detects communication problems between nerves and muscles.

Myasthenia gravis stages

There are five main classifications of myasthenia gravis that a doctor may use during a diagnosis:

• Class I: Muscle weakness only affects patient’s eyes (ocular muscle).
• Class II: Muscle weakness is mild.
• Class III: Muscle weakness is moderate.
• Class IV: Muscle weakness is severe.
• Class V: Severe muscle weakness affects how patient breathe. Patient may need intubation or mechanical ventilation.

In allopathy, there’s no cure for myasthenia gravis. Allopathic treatment is just to help manage patient’s symptoms. Treatments may include:

• Medications: Certain medications can reduce patient’s symptoms.
• Monoclonal antibodies: Patient will receive intravenous (IV) or subcutaneous (SQ) infusions of biologically engineered proteins (artificially made). These proteins may suppress an overactive immune system.
• Plasma exchange (plasmapheresis): An IV connected to a machine removes harmful antibodies from patient’s blood plasma and replaces them with donor plasma or a plasma solution.
• IV or SQ immunoglobulin (IVIG or SCIG): patient will receive IV infusions of donor antibodies over two to five days. IVIG or SCIG can treat myasthenia crisis, as well as generalized myasthenia gravis.
• Surgery: A thymectomy is surgery to remove the thymus gland.

Myasthenia gravis allopathic medications

Common medications to treat myasthenia gravis include:

• Cholinesterase inhibitors (anticholinesterase): They boost signals between nerves and muscles to improve muscle strength.
• Immunosuppressants: Medications like corticosteroids decrease inflammation and reduce body’s production of abnormal antibodies.

Side effects are sure with these medications.

Homeopathic Treatment for Myasthenia gravis

There are certain homeopathic medicines for myasthenia disease. These must be prescribed by an experienced doctor before intake, do not self-medicate please. The medicines are as follows:

1. Phosphorus:

Paralysis, Restless, fidgety. Hypo-sensitive, Vertigo, Heat from spine, Neuralgia, Burning pains. Myasthenia gravis. Chronic congestion of head; Brain-fag, Hippocratic face readings, ascending sensory and motor paralysis from ends of fingers and toes, Weakness and trembling, from every exertion, Arms and hands become numb, post-diphtheritic paralysis.

2. Mygale:

It is quite characteristic of the spider poisons to produce spasmodic diseases, depressed, the muscles of the face twitch constantly, the mouth and eye open and close in rapid succession, the head is jerked to one side, usually the right control over the muscle seems to be lost, If the patient attempts to put his hand to his head it is jerked backwards violently, and words are jerked out in talking, The legs are in motion while sitting, and dragged while attempting to walk.

Myasthenia gravis. Uncontrollable Movements of Face, Arms, and Legs, Involuntary head movements, throwing the head backward and then forwards are prominent, Constant jerking of the head (mostly to the right side), Shrugging of shoulders, difficulty in putting out tongue and grating of teeth at night.

All symptoms get better during sleep and are worse in the morning.

3.Agaricus Muscarius:

For chorea and myasthenia gravis, with Uncertain, Unsteady Gait –  Agaricus is well-indicated for cases of myasthenia gravis where an uncertain, Clonic spasms when awake, quiet when asleep, Though jerking when going to sleep; spasmodic motions, from simple involuntary motions and jerks of single muscles to a dancing of the whole body, Attack crosswise ,an upper right and a lower left extremity, or vice versa, Convulsive condition of the muscles of head and neck, constantly, Extreme mobility of lower limbs and the body generally, Frequent nictitating of eyelids; twitching and spasms of eyeballs; redness of inner canthi of eyes; lachrymation.

Body convulsed, as if a galvanic battery were applied to the spine. Ravenous appetite, but difficulty of swallowing, Cervical glands swollen; inarticulate speech, itching of eyelids and of different spots on skin, resembling chilblains; weakness and coldness of limbs; unsteady walk.

4. Cina:

Myasthenia gravis. Chorea or Hemiplegia Affecting Face and Upper Limbs, Cina is a helpful remedy for chorea affecting the face and upper limbs. Myasthenia gravis. The involuntary movements on the face are marked around the eyes. Another feature is throwing of arms from side to side. The limbs are distorted with jerking and trembling. A weakness of the hand is also present, making it difficult to hold things. Complaints usually appear on one side. Few general symptoms like irritability, screaming, striking and restless sleep may also be present.

5. Causticum:

For Right-Sided Chorea, myasthenia gravis. Causticum is the next prominent medicine for managing muscular weakness. Causticum is most indicated in cases of chorea when the right side of the body is more affected. The face, tongue, arm, and leg get affected. Twisting and jerking of limbs. An unsteady gait is present with involuntary body movements. Weakness of muscles is also present with the above symptoms.

Worsening of symptoms may be noted during the night. Causticum is also indicated for chorea during pregnancy.

6. Cuprum Metalicum:

Jerking of arms and legs. The arms and legs also feel weak, weary and lame. There may be muscle contractions. Jerking of hands is also present. The person can hold nothing in hand and the objects fall to the ground. Myasthenia gravis. Speech is also affected with trembling of the tongue.

Choreic movements start in the muscles of the fingers and toes and extend to the limbs. Myasthenia gravis. Better or quieter during sleep, but when awake the terrible contortions and awkward movements are excessive.

7. Magnesia Phos:

For Chorea or Hemiplegia when Symptoms are Better During Sleep, Magnesia Phos is an important medicine. Involuntary shaking of limbs, face, mouth, and head is present. Involuntary movements of limbs along with contortions may also appear. Myasthenia gravis. Sudden forward motion of the head is well-noted, jerking of the mouth and speech is also very defective.

8. Veratrum Viride:

For Chorea or Hemiplegia when Symptoms are Worse during Sleep. Involuntary motions of facial muscles (face turned into horrible contortions), jerking/continual nodding of the head, jerking of arms and legs, Constant movement of the lower jaw, speech affected, with the dropping of words when speaking. Myasthenia gravis.

9. Secale Cor:

Secale Cor is used in cases of Chorea or Hemiplegia when the chief indication is symptoms beginning in the face and then spreading all over the body. The symptoms may become severe and rise to dance and jumping. The arms and legs are in constant motion. Myasthenia gravis. Head movement from side to side is present, trunk in constant motion, tongue jerks out and speech becomes difficult and indistinct.

10. Kali Bromatum:

Kali Bromatum is a significant medicine to treat violent myasthenia gravis chorea or hemiplegia that arises from fright. Trembling of hands (Parkinson’s disease).

The gait is unsteady, irregular, and staggering (similar to a drunk person walking), facial muscles could be affected, the tongue protrudes with a jerk, and the person can barely speak. All the movements are violent.

10. Saccharum Lactis (Lactulose):

Amblyopia. Angina pectoris. Body-odor, offensive. Diabetes. Dyspepsia. Earache. Gout. Headache. Hysteria. Labia, soreness of. Nervousness. Neuralgia. Ovaries, affections of. Over-exertion. Ptosis. Sciatica. Sighing. Stye. Myasthenia gravis. Fear and trembling of whole body, Longing and melancholy, Hysteria in evening, laughing and crying, jumping up and lying down, but could not stand, head felt all drawn, Inflammation and awful pain in lower limbs extending down.

11. Belladonna:

Belladonna acts primarily on the brain, great general sensitiveness, sensitiveness of the special senses-sensitive to light, hydrophobia, remarkable quickness of sensation and/or of motion, melancholy, with grief, hypochondriacal humor, myasthenia gravis, moral dejection, and discouragement, delirium, and mania, with groaning, disposition to dance, to laugh, to sing, and to whistle.

Mania, with groans, or with involuntary laughter; nocturnal delirium; delirium with murmuring; delirium, during which are seen wolves, dogs, fires, &c; delirium by fits, and sometimes with fixedness of look, Stupefaction, with congestion to the head; pupils enlarged. Delirium. Great apathy and indifference, desire for solitude, dread of society and of all noise. Repugnance to conversation. Disinclination to talk, or very fast talking.

Ill-humor, disposition irritable and sensitive, with an inclination to be angry and to give offence. Folly, with ridiculous jesting, gesticulations, acts of insanity, impudent manners. Fury and rage, with desire to strike, to spit, to bite, and to tear everything, and sometimes with growling and barking like a dog. Dejection and weakness of mind and body. Dread of all exertion and motion.

Loss of consciousness. Fantastic illusions (when closing the eyes); Dementia, to such an extent as no longer to know one’s friends, illusions of the senses and frightful visions. Complete loss of reason, stupidity, inadvertence, and distraction, inaptitude for thought, and great weakness of memory. Memory: quick; weak; lost.

12. Sepia:

Convulsive motions of head and limbs, when talking jerking of facial muscles, General muscular agitation; desire to change constantly place and position, Ringworm like eruptions on skin every spring. Uterine chorea with menstrual irregularities; Amelioration after menses and after a thunderstorm. Myasthenia gravis.

13. Opium

Emotional chorea; trembling the head, arms and hands., Arms are thrown out at right angles with the body and spasmodic jerking of the flexors; convulsive movements of one or other arm to and fro, Twitching continue during sleep. Myasthenia gravis.

14. Tarentula Hispanica

For Chorea or Hemiplegia Tarentula Hispanica indicated when the chorea or hemiplegia like movements affect the right arm and right leg, and when the movements continue even at night, and are brought on by fright, grief, etc., restless and compelled to keep constantly in motion, the spine is sensitive, and there is trembling. Myasthenia gravis.

The patient can run better than he can walk, it is the remedy when diversion of the mind, especially music, relieves.

15. Zincum met:

Constant motion of the feet, which may continue during sleep, it is especially the remedy when the chorea is brought on by suppressed eruption or by fright, the general health is involved, right side most affected, much depression and irritability. Myasthenia gravis.

16. Cimicifuga:

Homeopathic medicine of myasthenia gravis chorea or hemiplegia indicated when the movements affect the left side and are associated with muscle pain or rheumatic joint ailments, or when reflex from uterine derangements, then Cimicifuga is the remedy, There is sensitiveness of the spine and entire muscular system, If mental depression be present it is an additional indication, Cimicifuga is especially indicated in chorea in young girls, about the age of puberty, with menstrual disorders, especially suppression of menses, Fright chorea and chorea with loss of power of swallowing indicate the remedy, Sleeplessness is an important symptom, Difficult speech, patient bites tongue when talking are good indications.

17. Causticum:

Myasthenia gravis. The muscles of the face, tongue, arm, and leg are all involved, Words are jerked out when talking, Patient continually changes his position, throws himself about until he falls asleep exhausted, during sleep legs and arms “on the go;” the child is unable to articulate because of excessive nervousness, Indisposition to talk because of weakness of the throat and tongue muscles.

P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).

For proper consultation and treatment, please visit our clinic.

None of above-mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.

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Gastroenterologist, Specialist Homeopathic Medicines.

  Senior research officer at Dnepropetrovsk state medical academy Ukraine.

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