Myasthenia Gravis

Myasthenia gravis (MG) is a chronic autoimmune disorder that results in progressive skeletal muscle weakness. Skeletal muscles are primarily muscle fibers that contain bands or striations (striated muscles) that are connected to bone. MG causes rapid fatigue (fatigability) and loss of strength upon exertion that improves after rest.

In early stages, myasthenia gravis primarily affects muscles that control eye movement (extraocular muscles) and those that control facial expression, chewing, and swallowing. If untreated, the disorder may affect muscles that control breathing (respiration), causing acute respiratory failure.

Types

Myasthenia gravis can be classified according to which skeletal muscles are affected. Within a year of onset, approximately 85-90% of patients develop generalized myasthenia gravis, which is characterized by weakness in the trunk, arms, and legs. About 10-15% of patients have weakness only in muscles that control eye movement. This type is called ocular myasthenia gravis.

Other types of MG include congenital, which is an inherited condition caused by genetic defect, and transient neonatal, which occurs in infants born to mothers who have MG. Congenital MG develops at or shortly after birth and causes generalized symptoms.

Transient neonatal MG is a temporary condition that develops in 10-20% of infants born to mothers who have MG. Transient neonatal MG is caused by circulation of the mother's antibodies through the placenta and it lasts as long as the mother's antibodies remain in the infant (usually a few weeks after birth).

Incidence and Prevalence

Myasthenia gravis affects approximately 2 out of every 100,000 people and can occur at any age. It is most common in women between the ages of 18 and 25. In men, the condition usually develops between 60 and 80 years of age.

Causes and Risk Factors

MG usually is caused by a malfunction of the immune system. The causative factor is unknown, but the disorder may have a genetic link. Causes include a genetic defect, which results in congenital MG, and the circulation of maternal antibodies through the placenta, which result in transient neonatal MG.

Acetylcholine (ACh) is a neurotransmitter that is involved in the transfer of information to muscle tissue. In myasthenia gravis, cells that bind to other cells to neutralize or destroy them (called antibodies) destroy acetylcholine receptor sites (AChR) in areas of muscle tissue that receive nerve impulses (called neuromuscular junctions), preventing nerve impulses from reaching the muscles. This results in weakness and rapid fatigue in affected muscles.

MG may be associated with other autoimmune diseases. Patients with family members who suffer from disorders such as rheumatoid arthritis, scleroderma, and lupus may have an increased risk for myasthenia gravis.

The thymus is an organ that produces cells involved in immune responses. It is located below the larynx and above the heart. Approximately 15% of MG patients have a tumor of the thymus (thymoma) and 60-80% have abnormal enlargement (hyperplasia) of the thymus. 

Treatment

Myasthenia gravis is one of the most treatable neuromuscular disorders. The choice of treatment depends on several factors, including age, overall health, severity of disease, and rate of disease progression.

Medications

Anticholinesterase medications such as neostigmine (Prostigmin®) and pyridostigmine (Mestinon®) are usually prescribed. These drugs prevent ACh destruction and increase the accumulation of ACh at neuromuscular junctions, improving the ability of the muscles to contract.

Side effects include excessive salivation, involuntary muscle twitching (fasciculation), abdominal pain, nausea, and diarrhea. A drug called kaolin may be used with anticholinesterase medications to reduce gastrointestinal side effects. Corticosteroids (e.g., prednisone) suppress the antibodies that block AChR at the neuromuscular junction and may be used in conjunction with anticholinesterase. Corticosteroids improve symptoms within a few weeks and once improvement stabilizes, the dose is slowly decreased. A low dosage may be used indefinitely to treat MG; however, side effects such as gastric ulcers, osteoporosis (bone thinning), weight gain, high blood sugar (hyperglycemia), and increased risk for infection may develop over the long term.

Immunosuppressants such as azathioprine (Imuran®) and cyclophosphamide (Cytoxan®) are used to treat generalized MG when other medications fail to reduce symptoms. Side effects may be severe and include low white blood cell count (leukopenia), liver dysfunction, nausea, vomiting, and hair loss.
Immunosuppressants are not used to treat congenital MG because this condition is not the result of an immune system malfunction.

Other Treatments

Plasmapheresis, or plasma exchange, is used to modify the immune system malfunction. It can be used to treat severe worsening of symptoms (exacerbations) or in preparation for surgery (thymectomy).

In this procedure, blood is removed from the body and blood cells are separated from the liquid portion of the blood (plasma). Then, AChR antibodies are removed and blood cells are diluted with artificial plasma (usually a solution of saline and sterilized human albumin protein) and infused back into the body. .Typically, 2 to 3 liters of plasma is removed and replaced during a single treatment, which takes several hours. Most patients undergo several sessions over the course of 2 weeks or more. Plasmapheresis improves MG symptoms within days and improvement lasts 6-8 weeks. Risks include low blood pressure, dizziness, blurred vision, and formation of blood clots (thrombosis).

Thymectomy is surgical removal of the thymus gland. It is usually performed on patients with a tumor of the thymus (thymoma) and patients younger than age 55 with generalized MG. Benefits of thymectomy develop gradually and most improvement occurs years after the procedure is performed.
Prognosis :Symptoms of myasthenia gravis usually progress to maximum severity within 3 years. After 3 years, patients usually stabilize or improve. Infants with transient neonatal MG may develop acute respiratory failure within a few weeks after birth.
Advances in medical care have reduced the mortality rate from respiratory failure in MG patients to approximately 3%. Patients over the age of 40, those with a short history of severe disease, and those with thymoma have a worse Prognosis.

Prevention

Myasthenia gravis cannot be prevented, but avoiding the following triggers may help patients prevent exacerbations: Emotional stress /Exposure to extreme temperatures /Fever /Illness (e.g., respiratory infection, pneumonia, tooth abscess) /Low levels of potassium in the blood (hypokalemia; caused by diuretics, frequent vomiting)/Medications (e.g., muscle relaxants, anticonvulsants, certain antibiotics)

REVERSE IT PROGRAM

We have a research protocol to offer clients to be done under the care of their physician. The Far Infra Red spinal stimulation bed is used routinely on a daily bases by client. This system reduces stress and relaxes client. In women we need to make sure we have a proper female hormone balance. The lack of female hormones contributes to neurological complications. The use of the bed does actually soothe the mind and body to rest and repair. It helps prepare for sleep as well. An evening session helps one sleep . We have oral amino acids for clients to try along with a body cream. We use the Far Infra Red Bed to help distribute the formula into the muscles.

Nerves when irritated best respond to cold. . The use of the heated bed can be balanced with ice rubbing treatments to focal areas. Also it is suggested that you make your ice packs from Lipton Tea . The tannic acid can soothe muscles and fine nerve endings. This is a common formula used in REVERSE IT. Brew a large amount of tea place wash clothes in it and then freeze, these to place on focal areas. They are also nice to place on the eyes or forehead during an InfraRed Bed treatment..

Please make sure you have had a Parathyroid test and the thymus examined, include an MRI or ultrasound.  Also have Mg and Ca levels drawn.

In any neurological condition we suggest that a full immunological work up and amino acid studies be performed. The formulas are titled Neurological Balance Formulas.

Oral Formula Neurological

AM:

Based on tyrosine aminoacid. Take this medication about 10 am with fruit juice. L Tryrosine 500mg. ,N Acetyl-L-Tyrosine 100mg ,P-5-P 25 mg ,B complex 50mg , Mg  20 mg.

Neurological AM Balance Cream for Full Body use. Please cover entire body including the neck area. Apply and use FIRBed for 20-20 minutes.  L Tyrosine 500mg , P-5-P 25 mg Mg 29 mg, RoseMary Fresh.

Oral Neurological Balance PM  L-typtopham 300mg , P-5-P 25 mg , Ca 400mg ,

Neurological Balance Cream

PM:

Tryptophan 400 mg/ Ca 400mg/ Niacin Leithicin activators/P-5-P 25 mg

Lavander Fresh . Use with FIR Bed 20-30 mins before sleep.

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