Myasthenia Gravis

What is Myasthenia gravis?

It is a chronic autoimmune neuromuscular disease characterized by weakness of the voluntary muscles of the body. It is basically caused by a breakdown in the normal communication between nerves and muscles. Pathogenesis includes inability of Acetylcholine (ACh) to bind to the receptors (AChR) on the postsynaptic membrane of Neuromuscular Junction.

What are the symptoms of Myasthenia Gravis?

• Drooping of upper eyelid or muscle weakness
• Facial paralysis
• Trouble talking
• Problems walking up stairs or lifting objects
• Difficulty swallowing or chewing
• Double vision
• Hoarse voice
• Fatigue

How is Myasthenia Gravis diagnosed?

To diagnose the condition, the doctor will review symptoms and medical history and conduct a physical examination. The doctor may conduct several tests, including:

Neurological examination

Doctor may check neurological health by testing your:
• Reflexes
• Muscle strength
• Muscle tone
• Senses of touch and sight
• Coordination
• Balance

The key sign that points to the possibility of Myasthenia Gravis is muscle weakness that improves with rest. Tests to help confirm the diagnosis may include:

Blood analysis

Doctors may recommend blood tests like AChR Antibodies test (Circulating anti-AChR Ab can be detected in 75–90% of MG and detection of these Abs is considered as “gold standard” for diagnosing MG. This test is a very valuable test in case of uncertainty in the diagnosis of MS), Anti-Skeletal (Striated) Muscle Antibody test, MUSK Antibody test (Beneficial as a screening test for MG in elderly especially when tests for AChR antibodies are negative), which may reveal the presence of abnormal antibodies that disrupt the receptor sites where nerve impulses signal your muscles to move.

Edrophonium test

Injection of the chemical edrophonium chloride (Tensilon) may result in a sudden, although temporary, improvement in your muscle strength. This is an indication that you may have Myasthenia Gravis.

Edrophonium chloride blocks an enzyme that breaks down acetylcholine, the chemical that transmits signals from your nerve endings to your muscle receptor sites.

Ice pack test

If you have a droopy eyelid, your doctor may conduct an ice pack test. In this test, a doctor places a bag filled with ice on your eyelid. After two minutes, your doctor removes the bag and analyses your droopy eyelid for signs of improvement. Doctors may conduct this test instead of the edrophonium test.

If you or your family members are facing any of these symptoms consult your doctor immediately.

Public awareness initiative by NeuroUNO – A super specialty division by Metropolis

Test Name Details Test Code Sample Schedule Report on
AChR Antibodies Acetyl Choline Receptor Antibodies A0012 3 ml Serum Daily: 7am Same day 6pm
ASKA Anti-Skeletal (Striated) Muscle Antibody A0483 2 ml Serum Mon and Thu: 9am Next day 5pm
MUSK Antibody MUSK IgG antibody M0080 2 ml Serum Tue: 9am Next day 5pm
Myasthenia Gravis Profile AChR, ASKA, MUSK M0081 3 ml Serum Mon: 9am 4th day