Frequently Asked Questions

What is a myasthenic crisis?

A myasthenic crisis occurs when the muscles that control breathing weaken to the point that ventilation is inadequate, creating a medical emergency and requiring a respirator for assisted ventilation. In patients whose respiratory muscles are weak, myasthenic crises may be triggered by infection, fever, or an adverse reaction to medication.

 

What are the outcomes for patients with Myasthenia Gravis? 

Without treatment, 20-30% of patients with myasthenia gravis will pass away in 10 years. However, with modern treatments, the outlook for most patients with myasthenia gravis is bright. They will have significant improvement of their muscle weakness and they can expect to lead normal or nearly normal lives. Some cases of myasthenia gravis may go into remission temporarily and muscle weakness may disappear completely so that medications can be discontinued. In a few cases, the severe weakness of myasthenia gravis may cause a crisis (respiratory failure), which requires immediate emergency medical care. 

 

Will I be able to have children?

Myasthenia gravis does not affect the normal growth and development of the fetus. Many women with MG have successful pregnancies.

 

What if I am pregnant? 

The effect of pregnancy on myasthenia gravis is variable. One third will get better, one third will remain the same and the remainder will get worse during the course of pregnancy. Typically, symptoms may worsen during the first trimester and an improvement in the third. 

Anticholinesterase medications and steroids have not been found to be associated with congenital abnormalities, and plasmapheresis has been safely carried out during pregnancy. In addition, the disease does not affect the smooth muscles of the womb, and complications during delivery are not very common.

 

Will my children get the disease? 

Myasthenia gravis is not an inherited disease hence it is not normally passed down from parent to child. There are some families that appear to have a genetic predisposition (they possess a gene that increases the risk of developing myasthenia gravis), but it does not necessarily mean that everyone in the family will get the disease. There is also no scientific proof to determine what genes could place a person at risk for myasthenia gravis and there are no tests for genetic screening. 

Infants of mothers with myasthenia gravis may be born with neonatal myasthenia gravis. There is a 12% to 20% incidence of neonatal myasthenia in infants born to mothers with MG. The child is weak at birth, but within a few weeks attains normal strength. This is usually self-limited, lasting 3-5 weeks but occasionally lasts longer, however it is not a permanent condition. The antibodies causing the disease in the mother are transferred to the child and then are eventually cleared from the baby's body. The child does not have myasthenia gravis. It is very rare for children of myasthenics to develop myasthenia gravis.

 

Where can I get treatment or advice for Myasthenia Gravis? 

Patients presenting with symptoms of myasthenia gravis should seek treatment from neurologists, especially one specializing in neuromuscular disorders. Often, the approach to the management of MG is multi-disciplinary involving other specialties as well as neurology such as neuro-ophthalmologists, cardiothoracic surgeons and oncologists, with the neurologists typically taking the lead.

 

Is Myasthenia Gravis contagious?

 

Although researchers are uncertain of the cause of MG, they do not believe that it is contagious.

 

Where can I get more information on Myasthenia Gravis? 

For more information on myasthenia gravis and other related diseases, you can refer to: 

  National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov

  Myasthenia Gravis Foundation of America, Inc: http:// www.myasthenia.org

  Muscular Dystrophy Association: http://www.mda.org

 Mayo Clinic, http://www.mayoclinic.com

 

References 

1. BR Thanvi, TCN Lo. Update on Myasthenia Gravis. Postgrad Med J     2004;80:690-700

2. Janice Roinson, MD, Milind J, Kothari, DO. Conn’s Current Therpy 2010, 1st edition.

3.  Taylor Harrison, M.D. Ferri’s Clinical Advisor 2010, 1st Edition.

4.  Angela Vincent, John Newsom-Davis. Cecil Medicaine, 23rd Edition.

5.  Website information from Myasthenia Gravis Foundation of America, http://www.myasthenia.org.

6.  Website information from Muscular Dystrophy Association, http://www.mda.org

7.  Website information from National Institute of Neurological Dosorders and Stroke,http://ninds.nih.gov