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Myasthenia Gravis


Treatment & Monitoring

What are the treatments for the disease?

There is no cure for myasthenia gravis. Lifestyle changes may improve the symptoms. The following measures may be helpful:

  • Avoid contact with people who have contagious infections.
  • Dress appropriately in very cold or very hot environments.
  • Eat a balanced diet high in potassium.
  • Follow the healthcare provider's recommendations for flu shots and pneumonia vaccines.
  • Get plenty of sleep.
  • Learn to manage stress.
  • Pace activities throughout the day to avoid fatigue.
  • Rest the affected muscles often throughout the day.
  • Seek effective treatment of underlying conditions, such as hypothyroidism.
  • Use good oral hygiene and get regular dental care.
  • Treatment of myasthenia gravis often involves medicines, such as the following:

  • anticholinesterases, such as neostigmine and pyridostigmine, which help nerves send impulses to the muscles
  • ephedrine sulfate, which can be given with other medicines to increase muscle strength
  • immunosuppressive medicines, such as prednisone, azathioprine, cyclosporine, and cyclophosphamide, which suppress the body's immune attack on the muscles
  • intravenous human immune globulin, or IVIG, which works for a short period of time by flooding the body with antibodies from many donors
  • Surgery to remove the thymus gland gets rid of the risk of tumors and often improves symptoms. Fifteen percent of the people with myasthenia gravis have a tumor of the thymus gland. This surgery may be recommended in a person who is otherwise healthy.

    Plasmapheresis is sometimes used. This technique allows removal of some of the person's plasma and plasma components. The remaining cells are reinfused. This produces a temporary reduction in circulating antibodies. This process can cause remarkable improvement in some people, but does not cure the disease.

    What are the side effects of the treatments?

    Many of the medicines used to treat myasthenia gravis can cause allergic reactions, stomach upset, diarrhea, and nervousness. Medicines used to suppress the immune system can increase the person's risk of infections. Surgery has a risk of bleeding, infection, and allergic reaction to anesthesia.

    What happens after treatment for the disease?

    If the person improves, he or she can resume normal daily activities. If the muscles involved in breathing are severely weakened, the individual may need a ventilator to help with breathing. Protection against choking or falls might be needed. Some people require intense treatment for long periods of time.

    A number of medicines aggravate myasthenia gravis. People are advised to consult with their healthcare provider before taking any new medicines. The person's dentist should be told that the person has myasthenia gravis, and that local anesthetic medicine such as novacaine might cause problems.

    How is the disease monitored?

    Any new or worsening symptoms should be reported to the healthcare provider.


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