Myasthenia gravis is a chronic autoimmune neuromuscular disease characterized by fluctuating muscle weakness and fatigue due to problems with signal transmission from nerves to muscles. It is caused by antibodies that block acetylcholine receptors, preventing muscle contraction. Symptoms may include drooping eyelids, double vision, difficulty speaking and swallowing, and weakness in arms or legs. Treatment focuses on medications to reduce symptoms by enhancing nerve-muscle signals or suppressing the immune system.

1. A REVIEW ON MYASTHENIA GRAVIS
Prepared By:-
Mr. Nirmal Gehlot
Supervised By:-
Mr. Pawan Tiwari

2.  Myasthenia gravis is a chronic neuromuscular disease that
leads to fluctuating muscle weakness and fatigue.
 The disease that is characterized by variable degrees of
weakness of the skeletal muscles.
 In MG, the muscle cells have problems responding to the
nerve impulses that normally signal them to contract.
 The disease usually does not reduce life expectancy. Most
people with MG manage their symptoms and lead active
lives.
 Women are most often affected in their 20s and 30s. Men
usually develop MG in late middle age.

3. 1. Ocular Myasthenia Gravis
Ocular myasthenia gravis only affects the
muscles that move the eyes and eyelids. The
symptoms of ocular myasthenia-
gravis include double vision (seeing two
images instead of one), trouble focusing, and
drooping eyelids.

4. 2. Generalized Myasthenia Gravis
generalized myasthenia gravis affects muscles
throughout the body. The main symptoms of
GMG include weakness in the arms, hands,
fingers, legs, and neck, shortness of breath,
Difficulty swallowing.

5.  Myasthenia gravis was first recognized as a
distinct clinical entity by Thomas Willis, a 17th
century Oxford physician.
 The first modern description was made in 1877
by Samuel Wilks, a London physician. Towards
the close of the 19th century, primary muscle
diseases and diseases due to muscle were
studied by English, French, and German
physicians.
 The first descriptions of myasthenia gravis were
by Wilhelm Erb, and Samuel Goldflam

6.  Appear at any age
 In women, the onset between 20 and 40
years of age
 Among men, at age of 40-60
In India, MG is reportedly more common in
males than in females; the age of onset in
males is 60 to 70 and that in females is seen
to be in the 30.

9.  Myasthenia gravis is resulted by a defect in
the transmission of nerve impulses to
muscles.
 It occurs when normal communication
between the nerve and muscle is interrupted
at the neuromuscular junction.
 acetylcholine, which produces muscle
contraction under normal conditions, no
longer produces the contractions necessary
for muscle movement.

10. Motor Neurons releases
Acetylcholine
Which binds to
Nicotinic Acetylcholine on muscle cell
membrane
responsible for muscle contraction

11. IN MYASTHENIA GRAVIS
Auto antibodies binds with
nicotinic acetylcholine receptors
Acetylcholine unable to bind with nicotinic
acetylcholine receptor
Doesn’t respond to contract signal from CNS
Cause Myasthenia Gravis

12. Edrophonium test
 Injection of the chemical edrophonium chloride may result in a
sudden, although temporary, improvement in muscle strength.
This is an indication that person may have myasthenia gravis.
Blood analysis
 A blood test may reveal the presence of abnormal antibodies that
disrupt the receptor sites where nerve impulses signal your
muscles to move.
Single-fiber electromyography (EMG)
 Electromyography (EMG) measures the electrical activity traveling
between your brain and your muscle. It involves inserting a fine
wire electrode through your skin and into a muscle to test a
single muscle fiber.

13. C h o l i n e s t e r a s e i n h i b i t o r s
 Medications such as neostigmine, pyridostigmine (Mestinon) enhance
communication between nerves and muscles. These medications don't
cure the underlying condition, but they may improve muscle contraction
and muscle strength.
C o r t i c o s t e r o i d s
 Corticosteroids such as prednisone inhibit the immune system, limiting
antibody production.
I m m u n o s u p p r e s s a n t
 Immunosuppressant medications that alter the immune system, such as
cyclosporine, methotrexate.

14.  Avoiding respiratory infections.
 Maintaining strength and weight with proper
nutrition
 Reducing emotional stress.
 Inform the neurologist of other medications to
avoid drugs that interfere with treatment.
 Taking anticholinesterase drugs as prescribed to
minimize weakness in breathing muscles.