World Rare Diseases Day: What is Myasthenia Gravis, A Chronic Autoimmune Disorder That Causes Weakness in Facial Muscles?

A few disorders can greatly impact your daily life, causing discomfort and issues with movements. One such is myasthenia gravis (MG), an autoimmune neuromuscular disorder that causes weakness in the skeletal muscles responsible for movement. The muscle weakness worsens throughout the day with more activities that you do.

According to experts, drooping eyelids and double vision are often the first signs. You may also find it difficult to stand, lift objects, and speak or swallow. “This condition occurs when the body's immune system mistakenly attacks the communication between nerves and muscles, leading to muscle fatigue and weakness,” Dr. Vinit Banga, Director, Neurology & Head, Neuro-Intervention, Fortis Escorts Hospital, told Times now.

According to Dr. Banga, MG, which affects around 20 out of every 100,000 people around the world, usually targets the muscles in your eyes, face, neck, arms, and legs and affects your ability to:

• Move your eyes or blink
• Keep your eyes open
• Make facial expressions
• Chew, swallow, and talk
• Raise your arms and lift objects
• Walk upstairs or get up from a chair

What causes myasthenia gravis?

The primary cause of myasthenia gravis is a malfunction in the immune system. “In a healthy individual, nerve impulses send signals to muscles through a neurotransmitter called acetylcholine. This neurotransmitter binds to receptors on muscle cells, triggering muscle contractions,” said Dr. Banga.

However, in those with this condition, their immune system produces antibodies that block or destroy these acetylcholine receptors, preventing muscle activation and leading to weakness. While the exact cause of this autoimmune reaction is unknown, researchers believe genetic and environmental factors play a role. “Some cases of myasthenia gravis are linked to abnormalities in the thymus gland, which is involved in immune system regulation. In rare instances, myasthenia gravis may be associated with tumors of the thymus (thymomas), further suggesting a connection between the immune system and the disease,” said Dr. Banga.

The severity and progression of symptoms of MG vary from person to person, most of which include:

Many people experience drooping eyelids or ptosis, and double vision, or diplopia, which are often the initial symptoms.

Weakness in these muscles can lead to difficulty speaking, swallowing or dysphagia, and chewing.

Weakness in the arms, legs, and neck can result in difficulty walking, lifting objects, or holding up the head.

Respiratory Muscles In severe cases, MG can cause breathing difficulties, leading to a life-threatening condition known as myasthenic crisis.

While there is no cure for myasthenia gravis, several treatments can help manage symptoms and improve muscle strength:

Acetylcholinesterase inhibitors like pyridostigmine enhance nerve-muscle communication, while corticosteroids and immunosuppressants reduce immune system activity.

These therapies remove or neutralize harmful antibodies, providing temporary relief during severe flare-ups.

Surgical removal of the thymus gland can benefit some individuals, particularly those with thymoma.

Managing stress, getting adequate rest, and avoiding triggers can help prevent symptoms from worsening.

Physical therapy focuses on gentle exercises to maintain muscle function without over-exertion, while occupational therapy helps patients adapt daily activities to conserve energy. Speech and swallowing therapy assists those with bulbar symptoms, preventing aspiration and improving communication. Psychological support also aids in coping with fatigue and emotional stress.

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