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   Myasthenia Gravis  

What is Myasthenia Gravis (MG)?
The term Myasthenia gravis means grave muscle weakness. MG is a chronic progressive auto-immune disorder causing muscle weakness.

What happens in MG?
In MG, there is weakness of voluntary muscles (those controlled by will) and easy fatigability. This weakness comes up during periods of exertion and improves after rest.
MG is an abnormality of the transmission of signals at the Neuro-Muscular Junction (NMJ). (Signals travel from brain to muscles via the nerves and the place where nerve joins muscle is called neuro-muscular junction.)

Whom can it affect?
Females are affected more often than males
Age of onset in females is during second to third decade
Onset is after sixth decade in males
2 out of every 100000 people are affected by MG

Auto-immune nature of MG:
In MG, the bodys defense system forms cells (antibodies) against acetyl choline receptors
These receptors are required for transmission of signals across the NMJ
When these receptors are blocked, altered or destroyed by the antibodies, muscle contraction cannot occur normally. Causes of MG:
Thymus tumors or abnormal enlargement (hyperplasia)
Stress (aggravating factor in existing cases of Myasthenia Gravis)

Muscles usually affected by MG:
Muscles controlling eye and eyelid movements
Muscles of facial expression
Muscles of swallowing
Neck and limb muscles
Occasionally respiratory muscles

Symptoms of MG:
Drooping eyelids (ptosis)
Double vision (diplopia)
Difficulty in speech, slurred speech
Difficulty in swallowing
Nasal sounding speech
Weakness of neck muscles
Weakness of arms and legs
Symptoms are usually intermittent (i.e. come and go)
Symptoms may disappear for weeks and may appear again, later
Weakness tends to worsen as the day progresses and after prolonged activity

Myasthenia Crisis:
A condition in which respiratory muscles become severely weakened
Patient may have breathlessness, choking, aspiration of food
Myasthenia crisis is rare and may end in respiratory failure

Grades of MG:
Grade 1: Only ocular disease
Grade 2A: Mild generalized weakness
Grade 2B: Moderate generalized weakness
Grade 3: Severe generalized weakness
Grade 4: Myasthenia crisis

Triggers of Myasthenia Crisis:
Respiratory viral infections
Sudden withdrawal of steroids
Certain drugs
Psychological stress
Exertion (especially in hot climate)

Diagnosis of MG:
This is mainly based on clinical findings and a few supportive investigations:
  Antibodies to acetyl choline receptors

  EMG (Electromyogram)

  Repetitive nerve stimulation

  Tensilon test

  CT chest (for thymus abnormalities)

Allopathic treatment mostly includes:
Acetylcholine esterase inhibitors (Pyridostigmine)
Immunosuppressive drugs
Plasmapheresis (a procedure in which abnormal antibodies are removed from the blood)
Intravenous immunoglobulin (temporarily modifies the immune system and provides the body with normal antibodies from donated blood)
Surgical treatment: Thymectomy

Homoeopathic approach and scope:
Myasthenia Gravis is an autoimmune disorder, which means that there is a fault with the immune system, guided by genetic tendencies and other general factors. In other words, MG is a constitutional disorder, where the whole constitution needs to be addressed. MG is a progressively deteriorating condition, calling for some measures to arrest or control the disease process. Homoeopathic treatment being constitutional in nature, treats the disease at a deeper level, to achieve the following:

Control of the disease process
Symptomatic relief
Homoeopathy has shown its efficacy in reducing the frequency of relapses and improving the power and tone of muscles. However, it may be noted that the improvement with homoeopathy may not be as fast as one achieved by using the immunosuppressive medicines. The role of homoeopathy is more as long term control, rather than for acute crisis control. Homoeopathy with its constitutional approach works at deeper level and brings deviations of immune system back to normalcy and in consequence minimizes the need of exogenous neurotransmitters or steroids as prescribed by conventional treatment.

Suggestion about homoeopathic treatment:
For achieving the best results in the cases of MG, we recommend a strategic combination of homoeopathy with the conventional treatment.

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