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Myasthenia gravis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Myasthenia gravis (from the Greek  "muscle",  "weakness", and Latin: gravis "serious") is an autoimmune neuromuscular disease leading to fluctuating muscle weakness and fatigue.  The onset of the disorder can be sudden and symptoms can be intermittent, which often means that diagnosis is particularly tricky and can be delayed if the symptoms are subtle or variable.  It is also difficult to diagnose because "brain lesions can produce similar facial problems, for example, and lung tumours the same problems with breathing" [sic]

It is a relatively rare disease.  The disease incidence is 3–30 cases per million per year, but the figures are rising 'as a result of increased awareness'.  It is most common in women between 20 to 40 years old and people from 50 to 70 years old of either sex.

Symptoms

Myasthenia Gravis affects muscles.  They become progressively weaker and weaker and the person tires easily. 

The disease often starts with the face.  The muscles that control eye and eyelid movement, facial expressions, chewing and talking are especially susceptible. Symptoms  may also include a drooping of one or both eyelids, double vision due to weakness of the muscles that control eye movements, changes in facial expression, and impaired speech.

The disease may then progress to the rest of the body affecting various limbs as it spreads.  It can lead to paralysis of various limbs and an unstable or waddling gait, weakness in arms, hands, fingers, legs, and neck,  difficulty in swallowing, and shortness of breath.

In myasthenic crisis a paralysis of the respiratory muscles occurs.  These crises may be triggered by infection, fever, an adverse reaction to medication, or emotional stress.  Severe myasthenia may cause respiratory failure due to exhaustion of the respiratory muscles.  Before the disease was recognised and investigated, this could cause death.  

The following lists the symptoms according to the way they are classed medically and the progression of the disease: 

  • Class I: Any eye muscle weakness,  no other evidence of muscle weakness
  • Class II: Eye muscle weakness of any severity, mild weakness of other muscles
  • Class IIa: Predominantly limb or axial muscles
  • Class IIb: Predominantly bulbar and/or respiratory muscles
  • Class III: Eye muscle weakness of any severity, moderate weakness of other muscles
  • Class IIIa: Predominantly limb or axial muscles
  • Class IIIb: Predominantly bulbar and/or respiratory muscles
  • Class IV: Eye muscle weakness of any severity, severe weakness of other muscles
  • Class IVa: Predominantly limb or axial muscles
  • Class IVb: Predominantly bulbar and/or respiratory muscles (Can also include feeding tube without intubation)
  • Class V: Intubation needed to maintain airway

Causes

Superficially, Myasthenia gravis is supposed to be caused by "circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction,  inhibiting the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors [nAChR] throughout neuromuscular junctions".

There is more, I won't bother you with the detail, this is symptom based medicine talking, not cause based medicine.  What really causes Myasthenia Gravis?

Pharmaceuticals

Quite a number of pharmaceuticals are implicated in the symptoms of Myasthenia Gravis including

  • Chelating agents - People treated with D-penicillamine can develop MG symptoms. Their antibody titer is usually similar to that of MG, but both the symptoms and the titer disappear when drug administration is discontinued.
  • Immunosuppressants
  • Chemotherapy drugs - which seem to suppress the immune system

This LINK takes you to the eHealthme web site, where you will find an up-to-date list of all the actual pharmaceuticals implicated in causing this illness.  The list is not anecdotal but derived from the Adverse health reports submitted to the FDA and SEDA.

Inherited genes

According to researchers, there is a 'slight genetic predisposition' because researchers have noticed the illness runs in some families.    The assumption that just because many people in a family have the same illness or disease, it must be of genetic origin, is not correct;  it could equally well indicate exposure to the same environmental pathogen or stressor.  Furthermore, if genes are damaged or changed, they have to be damaged or changed by something.  And the main culprits at the moment are radiation, viruses and nanoparticles.

Viruses

There are a number of viruses implicated in the disease.  Research is still ongoing as to which ones they are...

We describe 6 cases of myasthenia gravis (MG) that developed several months after West Nile Virus infection. All patients had serologically confirmed WNV neuroinvasive disease. None had evidence of MG before WNV.  PMID:  23559196

Myasthenia gravis (MG) is an autoimmune disease mainly mediated by anti-acetylcholine receptor (AChR) antibodies. In the late onset, a thymoma, tumor of the thymus, is quite frequent. However, the events leading to thymoma and MG are not understood. …… Altogether, [our] results strongly suggest that MG-T could be linked to a viral infection. ….. Our data clearly demonstrate INF-I overexpression together with the activation of innate immunity pathways in thymoma-associated MG suggesting that MG might develop after a pathogen infection. We were not able to relate thymoma to HPV infections and the implication of other pathogens is discussed. PMID:  24440286

Vaccines 

As viruses are implicated in the disease, any vaccine that uses a live virus is also implicated in the disease. 

Parasites

Quite a number of parasites are begining to be investigated and case histories are appearing of people investigated after death:

A 64 year old Myasthenia Gravis patient was admitted with pulmonary insufficiency. The autopsy revealed diffuse Strongyloides stercoralis infection.  PMID:  23885467

Bacteria

Often the emergence of bacteria as the cause only surfaces when a person is admitted for complications of the medications he is put on, or the further illnesses the medications or bacteria produce:

We present the first case of acute osteomyelitis of the mandible caused by Rhodococcus equi in an immunocompromised patient. A 53-year-old Caucasian man was referred to the outpatient clinic, because of a swelling of the left submental and submandibular spaces. The patient was immunocompromised owing to medication against myasthenia gravis and type II diabetes mellitus. Infection with this organism is rare and usually causes a distinct clinical syndrome resembling pulmonary tuberculosis. Diagnosis is frequently missed or delayed. PMID:  22986251

Toxins

Including Nanoparticles and Heavy metal poisoning  and not forgetting dental amalgam fillings. Smoking and smoke is a toxin in this respect.

Early days here.  There are speculative papers on Pubmed that link Myasthenia Gravis to a number of toxins, but not many case histories to draw on.

Fungal infections

Lots of papers citing various fungal infections, for example

Acta Derm Venereol. 2013 May;93(3):358-9. doi: 10.2340/00015555-1452.  Deep pseudocystic dermatophytosis caused by Trichophyton rubrum in a patient with myasthenia gravis.  Matsuzaki Y, Ota K, Sato K, Nara S, Yagushi T, Nakano H, Sawamura D.  PMID:  22949072

Other causes

The other causes still under investigation include

Treatment

Symptom based medicine - Myasthenia is treated medically with acetylcholinesterase inhibitors or immunosuppressants. It might be worth turning now to the section on Autoimmune diseases to get some background on why this may not be a good idea.

Cause based medicine - Find the cause.  As Myasthenia Gravis is a Muscle disease, I suggest you also turn to the section on Muscle diseases, to get a more general idea of the causes and treatments available.  In this section I have listed only what is currently known of the disease, but a wider perspective may be needed.

 

How it works

Whatever pathogen is causing the disease crosses the blood brain barrier - possibly helped by the use of immunosuppressants interfering with the natural immune response and then causes the spiritual experiences by attacking the brain.  As such all experiences are ultimately caused by Brain damage.

Observations

There are examples in the medical web sites of people who have had hallucinations from myasthenia gravis, however, I want to use one person of particular interest as she is a bit different and had some very intense visions, dreams and hallucinations – Julian of Norwich.

Related observations