Myasthenia Gravis

WHAT YOU SHOULD KNOW:

• Myasthenia gravis, or MG, is a disease of the nerves and muscles. Normally, when impulses (signals) travel down the nerve, the nerve endings release a chemical substance called acetylcholine. With MG, there is a defect in how acetylcholine is received by muscle cells. This results in problems in the movement of muscles. Muscles of the eyes, face, neck, arms and legs are commonly affected by MG. Muscles used in swallowing and breathing may also be affected. MG is most common in young women 20 to 30 years of age, and in men 60 to 70 years of age.
  
  
• MG is caused most commonly by a problem in the immune system, such as an autoimmune disease. The immune system is your body's defense system against infections and disease. Symptoms commonly include drooping of the eyelids, drooping of the facial muscles, slurring of speech, and blurring of vision (eyesight). Symptoms may get worse and cause problems with swallowing and breathing.
  
  
• Tests to diagnose MG include blood tests, a tensilon test, and electromyography (EMG). Treatment includes medicines, plasmapheresis, and surgery to remove your thymus gland. Ask your caregiver for more information about these tests and treatment.

INSTRUCTIONS:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• You may be taking anticholinesterase medicines to help your muscles and nerves work better together. This medicine may be taken with steroids to improve your energy, strength and slow your immune system. Both medicines may help a lot, but may have side effects. Do not stop taking these medicines until your caregiver says it is OK.
  
  
• You may be taking immunosuppressive medicines to slow down the immune system. The immune system protects your body from infections and diseases. But sometimes your immune system sees normal cells as bad. This medicine keeps your immune system from harming you. Sometime you take this medicine with steroids. Do not stop taking these medicines until your caregiver says it is OK.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Colds or the flu: Stay away from people who have colds or the flu. Ask your caregiver if you should get shots to keep from getting the flu and pneumonia. Also try to stay away from large groups of people. This decreases your chance of getting sick.

You may feel safer if you use a 4 prong (pointed) cane or a walker when walking. To keep from falling, remove loose carpeting from the floor. Using chairs with side arms and hard cushions will make it easier to get up or out of a chair. Put grab bars on the walls beside toilets and inside showers and bathtubs. These will help you get up after using the toilet or after bathing. Grab bars will also help to keep you from falling in the shower. You may want to put a shower chair inside the shower.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have diarrhea.
  
  
• You have more weakness than usual.
  
  
• You are having problems swallowing.
  
  
• You are so depressed you feel you cannot cope with your illness.
  
  
• You have questions or concerns about your condition and its treatment.

SEEK CARE IMMEDIATELY IF:

• You are having severe breathing problems. This may be a sign that you are having a myasthenic crisis. This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself.
  
  
  • Myasthenic crisis occurs when symptoms of MG get so bad that it affects the muscles of your lungs. This is a serious condition and may be caused by any of the following:
    
    
    • Certain types of medicines. Always make sure your dentist and other caregivers know that you have MG. Do not take any new medicine until you check with your caregiver first. Not taking enough medicine or not taking your medicine at all may also cause myasthenic crisis.
      
      
    • Infections and colds (viruses).
      
      
    • Physical activity.
      
      
    • Stress caused by pregnancy, surgery, or emotional upset.
      
      
    • Times before, during, or after your menstrual cycle.
      
      
    • Too cold or too hot temperature changes.
    
    
  
  

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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