What is Myasthenia Gravis (MG)?

Myasthenia Gravis (MG) is a neuromuscular disease and an autoimmune disorder that causes weakness in the muscles. Autoimmune diseases occur when the immune system mistakenly identifies the body's tissues as foreign and attacks them. The primary cause of Myasthenia Gravis is the immune system attacking receptors for acetylcholine, a neurotransmitter that facilitates nerve transmission. This attack results in nerve impulses not being transmitted to the muscles adequately, leading to weakness, fatigue, and a feeling of exhaustion in the muscles.

What Are the Symptoms of Myasthenia Gravis?

The symptoms of MG can vary depending on the muscles affected by the disease. Common symptoms include weakness in the face and eye muscles, double vision, drooping of the eyelids (ptosis), difficulty speaking and swallowing, weakness in the arms and legs, fatigue, and difficulty breathing. Symptoms often worsen with activity throughout the day and may temporarily improve with rest.

What Are the Causes of Myasthenia Gravis?

The exact cause of MG is not yet fully understood. However, factors such as genetic predisposition, environmental factors, and problems related to the immune system are thought to be influential.

The disease typically onset in young adulthood (20s-30s) and in the elderly (60s-70s). It is more common in women than in men.

How Is Myasthenia Gravis Diagnosed?

The diagnosis process involves evaluating symptoms and the patient's medical history. During a neurological examination, muscle strength tests are conducted. Nerve conduction tests (electromyography), single-fiber electromyography, and the ice test (observation of symptoms in eye muscles with cold application) may also be used. Additionally, blood tests can be performed to check for the presence of autoantibodies.

How Is Myasthenia Gravis Treated?

Treatment of MG aims to control symptoms, slow disease progression, and improve quality of life. Treatment typically involves a combination of medications, surgical interventions, or other treatment methods.

• Cholinesterase Inhibitors:
  These medications help increase acetylcholine levels by inhibiting its breakdown, which can slow the progression of the disease and improve muscle strength.
• Immunosuppressive Drugs:
  These drugs suppress the activity of the immune system when it is overactive. This aims to reduce autoimmune reactions and control symptoms of muscle weakness.
• Surgical Treatment:
  The thymus gland (an organ associated with the immune system) may be implicated in some cases of MG. In the presence of a tumor called thymoma, surgically removing the gland (thymectomy) can be an effective treatment method for controlling symptoms. Thymectomy may help reduce symptoms and decrease the need for medication in some patients.
• Plasma Exchange (Plasmapheresis):
  This treatment method is used to remove antibodies and other harmful substances from the patient's blood. Plasmapheresis can be used in acute exacerbations or emergency situations to rapidly control symptoms.
• Intravenous Immunoglobulin (IVIG) Therapy:
  IVIG involves administering high doses of antibodies obtained from donor blood intravenously. IVIG helps regulate the immune system and may contribute to controlling symptoms.
  
  

Treatment of MG should be individually planned for each patient, and the response to treatment may vary. The treatment plan is determined based on factors such as the severity of symptoms, the patient's quality of life, side effects, and other medical conditions. The treatment process should be managed with regular follow-ups and evaluations. MG treatment requires a multidisciplinary approach.