It is estimated that myasthenia gravis patients are all to often diagnosed as many as two years after the onset of symptoms. That’s because those symptoms, primarily weakness and fatigue, are common.
Diagnosing the disease is, in fact, a multi-step process. It starts with a look at your medical history and some physical examinations. At this point, the doctor is looking for eye or muscle problems that suggest myasthenia. For example, you may be asked to look upwards for a long time. In patients with myasthenia, this will induce a condition called ptosis, or drooping of the eyelids. Another approach is to test muscle strength after a repetitive task and then again after a period of rest.
Confirming the diagnosis is done in several ways. A blood test may be used to look for chemicals associated with the condition. Myasthenia is an autoimmune disease, in which the body produces antibodies that attack its own tissue. Blood tests look for two of those antibodies; 85 percent of myasthenia patients have acetylcholine-receptor antibodies, and many of the rest have muscle-specific tyrosine kinase, or MuSK, antibodies. These antibodies respectively attack the sites on the muscles that receive signals from the brain and the mechanism that transfers those signals from the nerve fibers.
Another procedure involves injecting a chemical called edrophonium that counteracts the immune response that causes myasthenia, though for too short a time to make it a practical treatment. If it does produce brief improvement, however, that is a strong indicator of myasthenia.
Once diagnosed, there are several treatment options available. Myasthenia has no cure, but medication and lifestyle changes can be used together to help reduce symptoms and improve a patient’s quality of life.
Patients need to take the effects of the disease into account, for instance by eating when they are well rested, and having more and smaller meals, to avoid problems chewing and swallowing. Railings can be installed in someone’s home to help provide support. An eye patch can alleviate double vision.
In addition to these workarounds, medications can help minimize symptoms. Immunosuppressants stop antibodies from attacking healthy tissue. Drugs called cholinesterase inhibitors boost the signal to the muscles that is diminished by myasthenia. You doctor can tell you about other treatment options and help you determine which is best for you.