Myasthenia gravis, a disorder in which the nerves of the muscles do not transmit the impulses properly, results in weakness of the muscles in the arms and legs. The disease may begin very gradually and take many months before the disability is severe enough for you to seek help. One of the first symptoms can be eye weakness, with difficulty in focusing and double vision from time to time. You may develop difficulty in speaking. The amount of weakness may vary from day to day and at different times during the day. Swallowing may become impaired, and you may have difficulty clearing the saliva from your throat.
An electromyogram and nerve conduction studies can help diagnose this disorder. Certain drugs that temporarily reverse the abnormality can be used to verify the diagnosis. Some people respond well to medications that improve the electrical impulses at the connection between the nerves and muscles; other individuals respond to cortisone treatment. It may be necessary to remove the remnants of the thymus gland, which sits behind the breastbone. In myasthenia gravis the thymus gland produces antibodies that interfere with the transmission of impulses from nerves to muscles. The gland usually atrophies after childhood but may persist in people with this disorder. Although this operation can be difficult, it frequently results in major relief of the symptoms, even though drugs may still be required for its control. Before surgery, some medical centers first treat patients with a blood exchange to clear the body of the substances that aggravate the disease. This temporarily improves the condition until surgery can be done. Not all medical centers are equipped for all aspects of therapy. A neurologist can direct you to the most suitable medical center in your vicinity.
Several other disorders can affect the muscles and nerves and cause weakness and pain, or both. Some illnesses occur with inflammatory conditions such as arthritis, whereas others result from virus infections or malignant disorders. At times it can be difficult to unravel the cause of muscle weakness and a muscle biopsy and special electrical studies are necessary. Some of these unusual ailments are treatable, whereas others will improve or progress depending on the nature of the underlying disorder.
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