How is Myasthenia Gravis (MG) treated?
If diagnosed promptly, some patients may be cured of MG by removal of the thymus gland (thymectomy) or aggressive immunosuppressant therapy. The effectiveness of treating MG depends on many factors, such as the severity of the disease, the duration of the disease, the patient’s age and the patient’s overall health. For the most part, however, MG can be well-controlled with the following treatment approaches:
- Cholinesterase inhibitors: These are commonly used drugs to treat MG, but they are most useful in mild forms of the condition. These drugs work by preventing the breakdown of acetylcholine, thus increasing the muscle’s ability to contract. The most commonly prescribed form of this drug is pyridostigmine (Mestinon).
- Immunosuppressants: Corticosteroids and other drugs such as cyclosporine and azathioprine help patients with MG by suppressing the activity of the immune system. These treatments are generally for more severely ill patients. Although they are often very effective, these drugs can have serious associated side effects. The patient should consult with his or her doctor regarding the potential value of these drugs in treating MG.
- Thymectomy: A thymectomy is a surgical removal of the thymus gland. There is evidence that thymectomy can lead to remission or reduced drug dependency, but it is more likely to work if undertaken within 6-12 months of the first onset of symptoms. A controlled clinical study of the efficacy of thymectomy in MG is currently underway.
- Plasmapheresis: Plasmapheresis is a blood plasma exchange process. It "filters" the blood of acetylcholine receptor antibodies by replacing the patient’s plasma with donor plasma. Plasmapheresis can be a life-saving tool in the treatment of MG; however, it is expensive, time-consuming, and can be associated with side effects such as low blood pressure, infection, and blood clots.
- IVIg: Intravenous infusion of immunoglobulin can modulate the immune system and reduce the effects of causative autoantibodies in MG. It is used to treat MG with acute worsening, especially with breathing involvement.
For patients with MG, a healthy lifestyle and education about one’s disease can maximize management. Some of the best ways to accomplish this include:
- Eating foods that are high in potassium such as bananas, tomatoes, apricots, and broccoli
- Avoiding overexertion
- Advising physicians of the diagnosis prior to taking prescribed drugs that may aggravate MG
- Avoiding excessive heat.