Myasthenia gravis, or in Hebrew tired muscle, is a deceptive disease. It causes weakness and severe muscle fatigue, but most of our lives are so busy – that there are quite a few people who attribute their hard feelings to overload or cumulative fatigue. But the truth is that it is a neuro-immunological disease that is very important to recognize, diagnose and treat quickly, as it can greatly disrupt life and cause great suffering to those who suffer from it and their family.
What is myasthenia gravis?
“The word myasthenia gravis means acute weakness in Latin,” explains Dr. Shachar Sheli, a specialist in neurology, neuromuscular diseases and peripheral neuroimmunology, in Sheba Hospital’s neurology department. The body due to self-production of antibodies. “These antibodies, explains Dr. Shelley, bind to the protein (the receptor in the muscle cell) and this protein is indirectly responsible for neurotransmitter and is located on the muscle wall, at the points of connection between the motor nerve and muscle.
What are the symptoms of the disease?
“Clinical symptoms in most patients begin with drooping of the eyelids mainly in the evening, accompanied by double vision. There is often weight loss, chewing fatigue and coughing after drinking fluids. Slightly bends the head, as the neck muscles get tired of holding the head upright, “explained Dr. Shelley,” there is also weakness of the limb muscle, i.e. the muscles of the shoulders and thighs, especially after activity. When you get up in the morning, there is freshness, but towards the end of the day, the weakness is obvious. ”
As mentioned, these symptoms create a diagnostic difficulty. “Because we all actually get tired at the end of the day and we all live a very intense lifestyle, it is very difficult to suspect that anyone who claims to be tired at the end of the day is sick with myasthenia gravis,” said Dr. Shelly, “so it is very important to know the disease “Vision, sudden weight loss, difficulty swallowing or drooping neck.”
How to diagnose?
“The disease is diagnosed by neurologists who specialize in muscular or neuromuscular diseases. The diagnosis is clinical, according to the patient’s story, and is combined with blood tests for antibodies and a neurotransmitter test (EMG) by an experienced neurologist,” explained Dr. Shelley. “Through this variety of tests – the clinical impression, the blood tests and the neurotransmitter test – it is possible to diagnose this disease.”
However, my doctor noted that many patients with myasthenia gravis find it difficult to get a diagnosis of their disease. And it’s unfortunate that every year you are not treated the difficulty back to normal functioning increases.
Who is at risk for myasthenia gravis?
In Israel, there are at least 800 to 1,000 myasthenia gravis patients diagnosed. “It’s a disease of young women and older men – it can happen in women aged 18 to 30, and in men especially over the age of 50” explained my doctor, but clarified that there can always be cases in both sexes, it is not binding. The prevalence of the disease is estimated About 20 patients per 100,000 residents.
How is it treated?
The disease has treatments that mainly suppress the immune system – such as steroids or other drugs that “press on the brakes of the immune system”. Dr. Shelley explained that because it is an autoimmune disease, these drugs in all sorts of indirect or direct ways contribute to a decrease in the amount of autoantibody production.
However, in 10 to 15 percent of patients there is a disease that is “resistant to treatment”, so they are the ones who need other solutions. “There are patients who do not respond to standard treatment and their condition continues to worsen,” said Dr. Shelley. “In Israel, there are 12 patients who have reported a significant improvement in their condition with this new treatment.”
Simply put, the new treatment works in a unique way in that it “prevents activation of an immune mechanism in the immune chain” in fact “the drug connects to the inflammatory conductor and stops it”, “like a dam in the middle of a river, you prevent further effects downstream”, explained my Dr.
“Because it is a disease that causes muscle weakness, can affect the swallowing muscles, respiratory muscles, limb muscles, and even cause life-threatening respiratory failure, it is important to hear more about treatment options, and to know the medications that can change patients’ lives.”
Does the disease increase the risk of other diseases?
First most myasthenia grafts have a tendency to develop other autoimmune diseases, except that in patients with myasthenia gravis, up to 20% of patients, also have benign cancer most often in the breast called thymoma, so those diagnosed with the disease should also do a chest CT to rule out a tumor. It is now known that thymus removal helps to control the disease. My doctor explained, “For years they have not understood the link between the diseases, but recently it has been speculated that thymus damage causes the development of an autoimmune disease, such as myasthenia gravis.”