Myasthenia Gravis

This is an autoimmune neurological condition with fluctuating weakness. The antibodies are formed against receptors in the neuromuscular junction. It occurs in different age groups and is mainly seen in middle-aged people (female predominant) and elderly (male predominant). It can affect only eye muscles or can affect other muscles of the body along with eye muscles.

Symptoms

• Fluctuating weakness of limbs worse at the end of day
• Double vision that keeps fluctuating
• Drooping of eyelids
• Change in the voice(Nasal twang)
• Swallowing difficulties and nasal regurgitation

Diagnosis

The diagnosis is with clinical examination

Neostigmine test

Repetitive nerve stimulation test (RNST) is also done as part of the investigation

Blood investigations for antibodies

Investigation for thymoma

Treatment

Myasthenia gravis is treated with medications that include symptomatic management and immune modulation therapies based on the severity. Early treatment can help in reducing disease progression. Tumor removal (Thymectomy) can also be done to facilitate better outcomes.