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The literal signification of the word “ myasthenia gravis ” is grave muscle helplessness . Myasthenia gravis is a rare autoimmune upset that occurs due to output of antibody against acetylcholine receptors ( AChR ) . The antibodies bond to these receptors and hence do n’t allow dressing of acetylcholine at the receptor site thereby leading to minify action of acetylcholine . Due to this there is blockage of face signaling transmittal and hence muscle failing results . The relative incidence pace of this disease is 0.25 to 20 amongst 1,000,000 population , yearly . This is a inveterate disease . It can be diagnosed with the help of tests like edorphonium test , electromyography and try the comportment of acetylcholine receptor antibodies in the blood.(2 )
Can You Be Cured Of Myasthenia Gravis?
No , you’re able to not be cured of myasthenia gravis . It is a life tenacious disease . There are various handling options available that assistance in controlling the sign and symptoms of the disease but it is a non - curable disease.(1 )
Treatment With Pyridostigmine- Pyridostigmine is an anticholinesterase , this drug subdue the military action of acteylcholinesterase which is an enzyme that causes break down of acetylcholine . By blocking the action of acteylcholinesterase , the action of acetylcholine is prolonged . Along with sustain action of acetylcholine , this drug also diminishes the onslaught by antibodies at motor end plates . Pyridostigmine has side core like diarrhea , intestinal griping and these can be controlled with the assistance of a drug named propantheline .
Sometimes when this drug is given in excess , it may lead to cholinergic crisis . It occurs because of receptor engine block at the motor conclusion plates . The symptoms of cholinergic crisis are pallor , sweating , palsy , heftiness fasciculations , speck pupils and excessive salivation .
Intravenous Immunoglobulin ( IVIg)- By hold intravenous immune serum globulin , the production of antibodies step-down and also a rapid improvement in the condition of the affected role is seen as the failing fades away quickly .
Plasmapheresis- In this operation , the blood is made to fall through a automobile that split the blood plasma containing antibody in the blood of patient role and in turn , supplant it with plasma that is destitute of antibodies . This is done only in severe pillowcase .
handling With Corticosteroids- Corticosteroids are the drugs that aid by subjugate the product of antibodies in the blood but these drugs have major side effect . Once start , corticosteroids are continued for month or may be for years .
Immunotherapeutic Agents- Immunotherapeutic agents are add to the handling to abridge the dosage of corticosteroids and are also helpful when corticoid are needed to be retire . The most commonly used drug is Imuran . seldom mycophenolate is also used .
Thymectomy- Thymectomy is a operative procedure where the thymus gland is surgically removed from the body . Thymus is a gland that take part in yield of antibodies . But this handling pick does not result in cure of disease but it surely assist in decreasing the symptoms and sign of the disease . Recurrence of the symptoms is also understand sometimes.(3 )
Complications Of Myasthenia Gravis
Myasthenic crisis is the most serious complication of myasthenia gravis . It is a lifespan threaten condition . In this condition the helplessness of muscles especially the diaphragm and heftiness of pectus that assistance in breathing , worsens to an extent that the patient might require ventilation or cannulisation because the muscle of pharynx countermine and this leads to compendium of respiratory secretion and hence closure .
The trigger broker that may have myasthenic crisis are-
Symptoms of myashtenic crisis-
intervention Of Myasthenic Crisis
Mechanical Ventilation And Intubation- Almost as much as 90 % of patients who undergo myasthenic crisis require mechanical ventilation and intubation . Suctioning- There is increase mucus production so regular sucking of these mucous secretion secretions must be done for right ventilation .
Anticholinesterases- Anticholinesterases must be administered in orderliness to increase the amount of acetylcholine at the muscleman end plates . This will better brawn strength .
Immunosuppressants- These will help in reducing the immune response and help in improving the symptom of myasthenic crisis .
Intravenous Immunoglobulins ( IVIg)- Injecting Ig will avail in reducing the severity of disease .
Plasma Exchange Or Plasmapheresis- The plasm from the line is secern and healthy plasma with no unnatural antibodies is infused into the trunk of patient and this helps by reducing the immune response.(3 )
Conclusion
Myasthenia gravis is an autoimmune disease that harm the neuromuscular junctions of the torso . There are acetylcholine receptors present at the neuromuscular junction that help oneself in contagion of the nerve caprice . In this disease antibody are produced against these sense organ and hence the spunk transmission is strangle . This disease can be care with the help of medications but no cure is yet available for this disease .
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