Myasthenia symptoms, causes and diagnosis. Myasthenia - what is this disease?
In the medical environment, myasthenia is a condition of weakness and rapidly advancing muscle fatigue. And this autoimmune disease is provoked, as studies have shown, a violation of the normal connection between the nervous and muscular tissue.
The disease, which will be devoted to this article, can not be called common. According to recent studies, only 5 out of 100,000 people are exposed to it. But, unfortunately, the tendency to myasthenia is growing. This means that we should know in more detail the symptoms and causes of the appearance of this pathology.
Myasthenia: what is this disease?
In a healthy person, the feeling of muscle fatigue occurs after some prolonged action or serious physical effort, and in a patient with myasthenia, this condition is triggered by completely ordinary things: talking, eating, short walks, etc.
With the diagnosis of myasthenia, the symptoms in the form of muscle fatigue become especially noticeable when they re-tension, and after a rest, as a rule, the patient's condition returns to normal. But, unfortunately, over time, the symptoms of the described pathology increase: fatigue occurs in an increasingly short time, and recovery requires an increasing amount of time.
Incidentally, due to the fact that during the day the patient has fatigue, it manifests itself more or less in the initial stage of the pathology is often classified as hysteria, although it was noted during the diagnosis that myasthenia is characterized by the absence of sensitivity disorders, as well as vegetative disorders
What signs are not typical for myasthenia
To determine the disease you need to know that myasthenia symptoms are quite symmetrical. It is not characterized by damage to the muscles, for example, one arm or one leg. True, the omission of one century is a frequent manifestation of this disease.
But headaches, dizziness, problems with urination, numbness of the hands or feet, as well as pain in the muscles of the extremities are not related to the signs of myasthenia.
In the described pathology, by the way, the distal parts of the muscles (hands, feet) retain their strength, and it is difficult for a patient, for example, to lift and hold hands in such a pose, to rise from a squat or go up the steps.
Myasthenia: eye shape
In the vast majority of patients with the above diagnosis, the first signals of the disease are problems with the organs of sight. As a rule, they are expressed by such symptoms as ptosis (spontaneous omission of one or both eyelids), as well as doubling of visible objects (in medicine this condition is defined as diplopia). These deviations are more pronounced when the eyeballs move to the side or, if necessary, peer into the image. It becomes difficult for the patient to even close his eyes.
A feature of the eye form of this pathology is the dynamism of its symptoms. So, ptosis can be more pronounced in the evening, disappearing after a night's sleep, and double vision during the day can change the severity.
Over time, myasthenia gravis (eye form), as a rule, spreads to other muscle groups. But in half of the cases the described disease does not go further than the organs of vision.
How does the damage to the muscles of the face and throat in myasthenia
About 15% of cases of the disease manifest symptoms associated with the functioning of the muscles of the face and throat. In medicine, this pathology is called bulbar disorders.
As a rule, at the first stage it looks like a gradual change in the tone of voice. In the process of a conversation, a person begins to nasal or utter words very quietly, hissing sounds and “p” are difficult for him (in medicine this is defined as dysarthria). Less commonly, these patients may develop hoarseness. And very rarely - modulation disorders, similar to stuttering.
Often the myasthenia syndrome, the symptoms of which we are dealing with, is accompanied by difficulties in the process of swallowing (this is especially noticeable when eating hot foods): the patient hardly swallows the food, coughs, the liquid can pour out through the nose. Long before the end of dinner, it becomes increasingly difficult for a person to chew, it comes to the fact that his lower jaw can drop (patients with myasthenia often help themselves when chewing by hand).
His mimicry is noticeably poorer: the patient hardly manages to puff out his cheeks, smile with one side of his mouth (mocking expression) or grin his teeth. Salivation also joins the above.
How myasthenia affects the muscles of the limbs and neck
If myasthenia muscles of the neck are affected, it is quite difficult for the patient to keep his head even. By the way, as a rule, these changes are most characteristic of elderly patients. They at the same time take a bent posture, and the head hangs forward (due to the weakening of the neck muscles).And for patients with localization of pathology on the limbs, even a short walk can be overwhelming.
Moreover, as the researchers noted, during exercise, the general condition of the patient changes. For example, after a tenfold squat, the patient may develop weakness not only in the legs, but also in the muscles of the arms, ptosis and even bulbar disorders.
By the way, the described disease progresses with any localization, but at the same time, ocular myasthenia may develop much more slowly than other forms of the disease, within a few years. Nevertheless, such symptoms greatly complicate the patient's life, which means that he needs urgent medical consultation.
How is manifested generalized myasthenia
If a patient has all the muscles of the body equally affected, then this ailment is determined by doctors as myasthenia generalized.She initially has no specific symptoms, and patients complain of constant fatigue and weakness. Experts, relying on data from laboratory studies (and they do not have any significant changes), most often diagnose such patients as "neurosis". And only after some time, when the symptoms become apparent, and the patient's reflexes are exhausted, the diagnosis is revised.
The danger of this type of disease is that it develops weakness of the muscles of the chest and diaphragm, leading to respiratory failure, which seriously endangers the life of the patient.
The causes of myasthenia
To answer the question: “Myasthenia - what is this disease?”, One should understand its underlying causes.
In the nerve fibers of the human body produced neurotransmitters that deliver orders from the human brain to muscle receptors. With myasthenia gravis, the own immune system blocks conduction in the neuromuscular connections, which ultimately leads to the ailment described.
Researchers suggest that the thymus gland takes an active part in the production of antibodies.It is located in the chest (in its upper part), at the base of the sternum. This gland grows to 18 years, and then begins its involution, that is, the extinction of vital activity and reduction in size. In patients with myasthenia, as noted by the researchers, the thymus gland (also called the thymus gland) is abnormally large. Quite often a tumor is found in it, but mostly benign.
To aggravate the course of myasthenia, other factors can be fatal, such as physical exertion, various diseases, stress, prolonged exposure to the heat, as well as taking certain drugs, such as antibiotics.
Does myasthenia cause complications
Myasthenia, the symptoms of which were discussed above, may be for various reasons complicated by three types of crises: myasthenic, cholinergic and mixed. By the way, most often provokes their offensive bronchopulmonary infection.
For all types of crisis is characterized by a sharp aggravation of the symptoms of the disease, a violation of swallowing and respiratory function disorder.
The patient in this case urgently needs urgent hospitalization in the intensive care unit and connection to a respirator.
How is the diagnosis of "myasthenia"
As you probably already understood, that a correct diagnosis was made, it is very important to get to an experienced specialist. For him, even acquaintance with the history of the disease will be sufficient for the diagnosis of "myasthenia".
Diagnostics with additional methods of research is carried out in the form of a functional test to detect the syndrome of pathological muscle fatigue, prozerin test, decrement test (detecting the blocking of neuromuscular transmission), blood test for antibodies to titin and acetylcholine receptors, as well as computed tomography of the thymus.
In cases of complex diagnostics, studies of the conductive function of nerves, electromyography of muscle fibers, as well as biochemical studies are performed.
All this allows us to clarify the nature of the course of the disease and select the appropriate treatment.
Treatment of myasthenia
Usually, in the diagnosis of "myasthenia", treatment is prescribed in the form of taking anticholinesterase drugs ("Kalimin") and potassium drugs, since its high content significantly improves cell function.
In cases of speech impairment and swallowing, as well as severe muscle weakness, glucocorticoid therapy is prescribed in the form of taking the drugs Prednisolone and Metipred.
And the generalized form requires removal of the thymus gland (thymus gland) already during the first year from the onset of the disease. But in some types of pathology, thymectomy (removal of the thymus) is not indicated, since it is not effective.
In case of a late onset of myasthenia, immunosuppressive therapy is carried out with the help of the drugs Cyclosporin, Imuran, Cyclophosphanum. And in a situation of acute exacerbation of the disease, they give a good effect of plasmapheresis (purification of blood plasma), as well as the introduction of immunoglobulin intravenously.
Since myasthenia gravis has a chronic course, it is impossible to completely cure it. But the correct treatment of this disease leads to very impressive results, up to the disappearance of all the symptoms of pathology.
True, even if the remission lasts until the end of the patient's life, it is said about remission, and not about cure. Since at any time taking medications that are contraindicated in the diagnosis of "myasthenia", treatment of the flu without consulting a specialist or severe stress can lead to exacerbation.
A few words in the end
As you have probably already seen, myasthenia gravis is a serious and often severe disease that requires mandatory monitoring by a specialist and constant medication.
With the diagnosis of "myasthenia" disability - this, unfortunately, the most frequent lot of patients. However, disciplined patients can live for many years without deterioration and fully maintain themselves. It is only necessary to remember about the medicines that need to be taken according to the schedule drawn up by the doctor.
The main thing is to pay attention in time to the state of health, to unusual weakness in certain muscle groups and to have time to turn to an experienced doctor, then the disease can be permanently stopped. Be healthy!