Dr. M.J. Bazos, Patient Handout
About Your Diagnosis
Myasthenia gravis is a disease of the central nervous system that affects individuals of any age or ethnic group. It is characterized by sporadic muscular fatigue and weakness, occurring chiefly in the muscles of swallowing and chewing as well as the muscles of the eyes, face, and neck. The exact cause of myasthenia gravis not well understood, although it is believed to be a defect where the nerve meets the muscle. Also, the muscles of the arms and legs may become weak or easily fatigued. One of the first symptoms that many
patients notice is double or blurred vision, and/or drooping of the eyelids. The muscles that control breathing may also be affected, which may result in shortness of breath. The symptoms of myasthenia gravis may get better (remission) for a period, then may worsen (exacerbation) for a period. The amount of time between remission and exacerbation is unpredictable. Unlike other disorders of the central nervous system, the progression of myasthenia gravis is exceedingly slow. Myasthenia gravis is diagnosed by obtaining a medical history, performing a physical examination, and administering the “tensilon test.” This test is performed in the hospital. The medication (tensilon) is injected through an intravenous line, and the physician observes the effect of the medication on the symptoms. The test usually takes about 30 minutes, but the patient is often observed for an hour or longer. Your physician will discuss the risks and benefits of this test with you. You may also need a computed tomography (CT) scan of your neck and upper chest to look for enlargement of the thymus gland.
Living With Your Diagnosis
Myasthenia gravis may affect your vision. If you are having double or blurred vision, you should avoid driving or operating heavy equipment and you should consult your eye doctor. There may be times when your ability to swallow will be affected. During those times, try foods of different consistency to determine what is easiest. Often thin liquids such as juice and water are more difficult to swallow than thick liquids. If you take medications regularly, ask your physician about liquid formulations instead of tablets. One of the most frightening symptoms of myasthenia gravis is shortness of breath. This may occur at any time and may require medical attention. Your physician may request a test called a pulmonary function test. This is an office test that measures how well your lungs are working. It is usually done during a remission phase to determine a baseline so that testing during an exacerbation can be compared. If you have had shortness of breath, it is best to avoid smoke and dust. Wear a medic-alert bracelet or necklace in the event you have a sudden attack and need to be taken to a hospital. Fatigue is a common symptom of myasthenia gravis so get plenty of rest. You may need brief rest periods during the day (about 10–15 minutes). Avoid strenuous work that may increase fatigue. If you have a stressful job, learn ways to manage stress more effectively. Often, employers or local schools offer seminars on stress management. A regular exercise program will also help with stress management, but check with your physician before beginning any exercise program.
A short hospital stay is recommended to perform the necessary tests for diagnosis. Once the diagnosis is confirmed, treatment should begin. The goal of therapy is to treat the symptoms and to induce a period of remission. The most common medications used to treat myasthenia gravis are steroids and anticholinesterase medications (e.g., Mestinon). Your physician will discuss the medications and regimen best for you. Try to maintain a daily exercise program as advised by your physician and physical therapist. They will teach you the proper exercises to strengthen and tone your muscles.
The DOs
• Get plenty of rest.
• Wear a medic-alert bracelet or necklace at all times that has “myasthenia gravis” engraved on it.
• Take your medications as prescribed.
The DON’Ts
• Don’t use tobacco because it may worsen your shortness of breath.
•Avoid smoke (woodstoves, campfires).
•Avoid situations that may cause or aggravate allergies (pets, pollen, and dust).
When to Call Your Doctor
• If you have shortness of breath.
• If your symptoms worsen to include double vision, blurred vision, or weakness.
• If you have any problems associated with your medications.