What is it?
Myasthenia Gravis literally means “grave muscular weakness”. Myasthenia Gravis is a chronic autoimmune, neuromuscular disorder caused by a defect in the transmission of nerve impulses to a voluntary muscle, especially affecting skeletal muscles. It commonly affects extra-ocular muscle which leads to the drooping eyelids and double vision.
It is a type II hypersensitivity disorder that leads to abnormal muscular weakness.
The condition in which one’s immune system attacks one’s own tissues is an autoimmune disorder.
Hypersensitivity is a condition of any heightened and abnormal immune response to an antigen.
In Myasthenia Gravis Antibodies targeting acetylcholine receptors are produced by body cells which blocks muscular contraction signal by binding with the receptor. This also activates a complementary pathway that results in muscle cell destruction.
How common is it?
It is a rare disorder and around 1 million people per year in India are diagnosed with Myasthenia Gravis.
Worldwide around 20 people per one lakh suffer from Myasthenia Gravis.
Young women in their 20s-30s and older men in their 60s-70s are most likely to have Myasthenia Gravis. Although a person of any age may suffer from this.
What are the early symptoms?
The very first symptom of Myasthenia Gravis is tiredness and weakness. The person may wake up feeling fine but there is progressive weakness as the day ends.
A person with Myasthenia Gravis finds it difficult to do day to day activities like walking, chopping, holding things, talking, brushing hair, etc.
Other common symptoms of Myasthenia Gravis are:
- Ptosis i.e. prolapsed of bodily organs like drooping eyelids.
- Lethargy and heaviness in arms.
- Difficulty in keeping jaw clenched.
- Fluctuating Muscular weakness, weariness, and fatigue.
- Difficulty in mastication thus person is unable to finish meals.
- Dysphagia. difficulty in swallowing.
- Slur speech.
- Problem in vision (diplopiae. double vision).
Is it life threatening?
Generally, when diagnosed, complications of myasthenia gravis are treatable.
Thymectomy (removal of thymus where antibodies are produced) is performed. Even after thymectomy if symptoms reoccur, immunosuppressant drugs are given which may result in weight gain, osteoporosis, glaucoma, diabetes, etc.
Also in chronic cases, management is done with anti-acetylcholinesterase drugs that provide symptomatic treatment.
There are complications associated with myasthenia gravis this means there are chances of other autoimmune diseases like:
- Thymoma (10-20%)
- Thymic hyperplasia
When respiratory muscles and diaphragm are affected in myasthenia gravis it is myasthenia crisis which may be an emergency medical condition and can be life-threatening. Plasmapheresis is the available treatment for this condition. Difficulties in breathing and nasal speech are the symptoms. Also when a snarling face appears then it’s a serious condition.
What foods should be avoided?
Some foods and drugs may worsen the condition. It is much more important to know what to avoid than what to have.
- Foods which are dry and difficult to swallow like cookies.
- Foods which initiate inflammation e.g. dairy products, animal proteins including poultry and meats )
- Avoid processed sugar as much as possible.
- Avoid artificial sweeteners; e.g. soft drinks, fruit juice concentrates contain them.
- Avoid processed food as they contain preservatives and emulsifiers which may trigger the immune response.
- Avoid foods and drinks containing tannins e.g. coffee, berries, red wine, vanilla, cloves, etc.
- Raw beans, sprouts as they may give lectin, solanine
- Avoid aspiration (food or fluid enters lungs) by being careful with soupy foods having solids in them e.g. pasta
- Alcohol, Smoking and drug abuse.
- some drugs :
- antibodies like aminoglycosides (e.g. streptomycin, neomycin ), quinolones (e.g.ofloxacin, moxifloxacin)
- β blockers-used in hypertension (e.g. atenolol, propranolol )
- quinine-used in malaria
- class 1A antiarrhythmic drugs (e.g. procainamide)
- anticonvulsants (e.g. phenytoin)
- some muscle relaxants (e.g. atracurium)
- live and attenuated vaccines when on immunosuppressant therapy.
What is the best diet when you are suffering from this?
Diet plays a crucial role in being healthy and it’s very important to know what to eat, when and how. Since it is an everyday battle for those who are suffering from myasthenia gravis, they should make their diet a lifestyle and they will see it’s worth it.
- Have foods that are easy to swallow and slide down the throat more easily. For this:
- Chop, mesh and mince food.
- Include soups in the diet.
- Use dips and gravies.
- Take food rich in potassium (e.g. banana, broccoli) for symptomatic relief.
- Vitamin D and calcium-rich foods (e.g. cereals, almond milk, yogurt)
- Vitamin B rich foods as they promote nerve health (e.g. sweet potato, papaya, onion, pista, flax seeds, etc).
Reduce meal size and have meals 4-6 times a day.
Along with the diet it is also advised to have a good sleep, reduce stress and anxiety. For this, practice yoga and meditation.
And remember self-love, positive attitude, and strong will power is necessary to fight any disease.