Treatments for myasthenia gravis include medications to help control and prevent symptoms related to muscle weakness and therapies during a myasthenic crisis (when symptoms worsen). Surgical removal of the thymus (a small lymph gland) can reduce the immune process that causes myasthenia gravis. You may also need treatment to ease vision or breathing complications.

Medications and therapies for myasthenia gravis

Prescription drugs can help prevent it symptoms of myasthenia gravis in many different ways. In myasthenia gravis, the immune system attacks acetylcholine receptors.

acetylcholine is a neurotransmitter that mediates muscle function by transmitting a message from a nerve to a muscle. Reduced acetylcholine activity in myasthenia gravis leads to muscle weakness.

Therapies used for maintenance treatment or to treat myasthenic seizures (suddenly worsening symptoms) prolong the action of acetylcholine, sometimes by interfering with the immune system’s attack on this neurotransmitter.

Treatments for myasthenia gravis include the following medications.

Mestinon, Regonol (pyridostigmine): This maintenance medication is used daily to prevent symptoms. It works by preventing the breakdown of acetylcholine. Side effects can include stomach upset, nausea and diarrhea.

Soliris (eculizumab): This medicine is given as a scheduled infusion and is used for people who test positive for certain antibodies (a type of immune protein) in myasthenia gravis. Soliris inhibits the proteins that activate the inflammatory response (complement proteins) that facilitate the attack on the neuromuscular junction in myasthenia gravis.

Zilbrysq (zilucoplan): This drug prevents the production of certain complement proteins that can promote the immune process of myasthenia gravis. You self-inject this medicine daily.

Rystiggo (rosanolixizumab-noli): This drug prevents the survival of antibodies that target acetylcholine receptors in myasthenia gravis. It is administered as an infusion with scheduled doses.

Steroids, Azasan (azathioprine), Prograf (tacrolimus), cyclosporine, methotrexateand other immunosuppressants: Medicines that suppress the immune system are often used during a myasthenic crisis and sometimes to prevent symptoms. These treatments are nonspecific anti-inflammatory therapies that decrease immune activity in general—they do not specifically target myasthenia gravis immune proteins.

Plasmapheresis:A plasma exchange procedure it is sometimes used during a myasthenic crisis to remove antibodies that cause an attack on acetylcholine receptors. During this procedure, your blood is filtered to remove antibodies and blood cells are returned to the body. Plasmapheresis can cause a drop in blood pressure.

intravenous immunoglobulins (IVIG): This treatment involves infusing healthy antibodies to prevent harmful immune activity. It is used during a myasthenic crisis.

Side effects of treatment

Many of the treatments used for myasthenia gravis work by suppressing the immune system, which can lead to a predisposition to infections.

You may need to talk to your healthcare provider about how to avoid infections. This could include avoiding contact with people you know are sick, wearing a mask when you know you will be in public, and recommended immunizations.

In addition, some of the treatments used for myasthenia gravis can cause allergic reactions. If you have side effects of any kind with myasthenia gravis treatments, be sure to let your healthcare team know.

Emergency treatment

Myasthenia gravis can lead to dangerous emergencies if it affects your swallowing or breathing. Weak muscles can make you prone to choking, which can cause aspiration pneumonia or may lead to dangerous airway obstruction. Myasthenia gravis can weaken your muscles, affecting your ability to breathe.

With myasthenia gravis, your breathing can quickly become impaired, leading to dangerously low oxygen. During a myasthenic crisis, your team healthcare provider can monitor your oxygen levels so you can get breathing support if you can’t breathe adequately on your own.

Intervention and surgical procedures

If you have myasthenia gravis, you may need surgery. One type of surgery, thymectomy (removal of the thymus), is a treatment to prevent symptoms. Other surgical procedures can treat complications of the condition.

Thymectomy

Thymus gland mediates the body’s immune system. For some people with myasthenia gravis, surgical removal of the thymus gland is recommended to suppress the immune attack on the acetylcholine receptors.

Myasthenia gravis is associated with non-cancerous enlargement of the thymus gland, and sometimes people with myasthenia gravis have a cancerous thymus tumor.

You and your healthcare provider can discuss this option and decide if it is beneficial for you. Thymectomy can be curative, but some people still need to take medication for myasthenia gravis after thymectomy.

Stem cell transplant

Stem cell transplant is a procedure that involves infusing healthy immature immune cells that will develop into mature immune cells. Transplanted cells are infused to replace unhealthy immune cells. This procedure may allow you to take a lower dose of myasthenia gravis medication.

Before you have a stem cell transplant, you will need pretreatment with drugs to suppress your immune system.

Surgical treatment of ocular and respiratory complications

ptosis (a drooping eyelid) can occur due to myasthenia gravis. If your eyelid is interfering with your vision, surgical treatment can help improve your vision.

In rare cases, when myasthenia gravis causes severe breathing problems, it may require the placement of a tracheostomya semi-permanent breathing tube surgically placed in the throat.

Self care

Lifestyle factors are key to taking care of yourself when you have myasthenia gravis. This condition can make you tired, and your symptoms may worsen after you are active.

Exercise can be beneficial for maintaining overall health, but getting enough rest is important as wekk.

You may be advised to eat slowly to avoid choking or aspiration – food going up the airways instead of the esophagus. Or, you may benefit from swallowing therapy to help you avoid this complication.

You may also need to consider using assistive devices to help you get around. These may include a cane, a walker or a wheelchair. While you may not need an assistive device at home, you may need one for stressful situations like in an airport.

Summary

Myasthenia gravis is chronic autoimmune disease which affects muscle movement. Treatments include medications for maintenance therapy and myasthenic crisis (when symptoms worsen). These therapies can suppress the immune process that causes symptoms or prevent the breakdown of acetylcholine, a chemical the body uses in muscle movement.

You may need emergency treatment for breathing or swallowing complications. In addition, surgical removal of the thymus gland can help prevent the damaging immune process of myasthenia gravis.

You also need treatment if you develop complications, such as ventilator support for breathing problems. You have many treatment options for myasthenia gravis that can help you control and prevent symptoms and alleviate complications.