Myasthenia gravis is a disorder of the space where nerves meet muscles, known as the neuromuscular junction. It is an autoimmune disorder that usually results in fluctuating weakness related to exertion. The weakness is caused by circulating immune proteins called antibodies which block an important chemical called acetylcholine from activating muscles and generating strength.

The weakness can affect muscles of the face, eyes, arms, legs and rib cage with varying degrees. In severe cases symptoms can progress quickly over a few hours or even less time, requiring prompt attention from a neurologist familiar with myasthenia before weakness involves muscles important for breathing and swallowing.

The diagnosis of myasthenia gravis can be difficult and requires a thorough history and neuromuscular examination, as the symptoms can be subtle and hard to distinguish from normal variants and other neurological disorders. There are also other medical problems (such as thymus gland tumor or other autoimmune disorders) associated with myasthenia gravis which must be considered.

Tests carried out by Jaydeep Bhatt M.D. that help with the diagnosis may include:

• Blood tests to identify autoimmune markers
• EMG (a recording of electrical activity in muscles)
• Nerve conduction studies
• Imaging studies such as CT of the chest

There are many options for treatment and often a combination of therapies are used by neuromuscular specialists. There are oral medications that enhance the function of acetylcholine in the neuromuscular junction which help symptoms. Another class of oral medications are immunosuppresive agents which decrease the autoimmune response which causes myasthenia. For patients who are not good candidates or resistant to oral medications intravenous therapies that are given in the home, infusion center, or hospital are effective as well. Finally, a surgery known as thymectomy may also be required to control myasthenia gravis if a thymus gland tumor is found.