What are the symptoms of myasthenia gravis? What are the manifestations of myasthenia gravis?

Patients with myasthenia gravis often feel soreness and discomfort in the eyes or limbs, or blurred vision, fatigue easily, and fatigue worsens in hot weather or menstrual cramps. As the disease progresses, skeletal muscles become significantly fatigued and weak, which is characterized by muscle weakness that worsens after exertion in the afternoon or evening and decreases after getting up or resting, a phenomenon called "morning light and twilight heaviness".

Patients with myasthenia gravis can have skeletal muscles throughout the body affected and may have the following symptoms.

1) Dropy eyelids, blurred vision, diplopia, strabismus, and inflexible eye movement.

2) Indifferent expression, wry smile, large tongue, difficulty in arthria, often accompanied by nasal voice.

3) Weakness in chewing, choking on drinking water, and difficulty swallowing.

4) Weak neck, difficulty in raising the head, weakness in turning the neck and shrugging the shoulders.

5) Difficulty in raising arms, combing hair, going up stairs, squatting, and getting on the bus.

The performance is as follows. Ptosis of the upper eyelid: this is caused by paralysis of one or both extraocular muscles, which may be accompanied by strabismus and diplopia at the same time, and in severe cases, eye movement is obviously limited, or even the eye is fixed, but the pupillary sphincter is not affected, that is, the pupillary accommodation function is normal;

Dysphagia and chewing: This is caused by the involvement of the facial and throat muscles, and at the same time, there will be an indifferent expression, a wry smile, continuous chewing weakness, choking on water, and more laborious swallowing of chewed food when eating;

Myasthenia gravis.

Department: Department of Neurology.

The expert group of the medical code of Di Yuwei.

Chief physician of Xuanwu Hospital, Capital Medical University.

He is the leader of the neuromuscular disease group of the Department of Neurology, Xuanwu Hospital, Capital Medical University, and a member of the neuromyopathy group of the Neurology Branch of the Chinese Medical Association.

Overview** symptoms.

Seek medical attention** Prognosis daily.

The most common presenting symptom of myasthenia gravis is ptosis.

and binocular diplopia. Patients may also have muscle weakness in the extraocular muscles, laryngeal muscles, or extremities alone at the beginning of the disease. This is followed by the gradual involvement of more skeletal muscles, from the face and limbs to the respiratory muscles, affecting normal life and even life-threatening.

Typical symptoms. The main symptoms are as follows:

Ptosis: This is caused by paralysis of one or both extraocular muscles and may be accompanied by strabismus.

In double vision, in severe cases, eye movement is significantly limited, or even the eyeball is fixed, but the pupillary sphincter is not affected, that is, the pupillary accommodation function is normal;

Dysphagia and chewing: This is caused by the involvement of the facial and throat muscles, and at the same time, there will be an indifferent expression, a wry smile, continuous chewing weakness, choking on water, and more laborious swallowing of chewed food when eating;

Hoarseness: This is also caused by the involvement of the facial and throat muscles, which can be accompanied by nasal speech, dysphonia, and unclear pronunciation when speaking;

Difficulty raising head: when the sternocleidomastoid muscle and trapezius muscle are involved, it manifests as neck weakness, difficulty in raising the head, weakness in turning the head and shrugging the shoulders;

Weakness of the arms and legs: The muscles of the limbs are affected by proximal weakness, which is manifested as difficulty in raising the arms, combing the hair, and climbing stairs, but the tendon reflexes are usually unaffected and the sensation is normal;

Dyspnea: Respiratory muscle involvement often leads to adverse consequences, and medical attention should be sought as soon as possible if you experience difficulty breathing;

Morning and evening severity: this is a characteristic of the symptoms of the disease, i.e., daily fluctuations, muscle weakness that worsens after exertion in the afternoon or evening and lessens after morning or rest.

Myasthenia gravis is a chronic autoimmune disease that causes skeletal muscle weakness and extreme fatigue due to abnormalities in the neuromuscular junction.

It is more common in women than men and can occur at any age, but is most common in young women and men over 50 years of age. Most of these diseases are not inherited, but are autoimmune-related, that is, the body's immune system is abnormal, attacking normal tissues, resulting in a series of damages.

The main symptoms of myasthenia gravis are drooping eyelids, double vision, difficulty swallowing, stiff expression, and muscle fatigue and weakness of the hands and legs, especially the ocular symptoms. Seizures are characterized by muscle weakness that becomes more and more weak after repeated use, which improves significantly with rest, but worsens with activity.

Weakness, the most typical appearance is that the eyelids cannot be raised.

Myasthenia gravis is manifested as skeletal muscle weakness that is severe in the morning and evening, which is a phenomenon of skeletal muscle fatigue, such as the patient's general strength is good in the morning, but he feels bored in the evening. Or when you open your eyes, both eyes are the same size, but when you read a book or TV for a while, one eyelid slowly falls off, and you can't even see anything from the cornea. This phenomenon of muscle fatigue should be considered whether it is myasthenia gravis.

It is manifested as sick fatigue, which is not the fatigue of running a marathon, but the inability to hold on to seeing things for one minute, such as holding on to two minutes with both hands raised, and a dramatic improvement after resting, called pathological fatigue. If the above situation occurs, you should go to the hospital to have a doctor for a neurological examination, mainly to check how well the muscle endurance and fatigue are. If the fatigue test is positive, a neostigmine test can be done to confirm the diagnosis, to see if there is a significant or dramatic improvement after the injection, and if so, myasthenia gravis should be considered.

The early symptoms of myasthenia are generally drooping eyelids, light in the morning and heavy in the evening, and some are double vision, or the most awake myasthenia gravis, which is not a manifestation of simple eye muscle gravis. Often, these patients will develop other symptoms over time, such as difficulty in swallowing and speaking, which will gradually worsen to breathing and weakness in the limbs.

Myasthenia gravis is a less common disease, which is generally caused by genes, and there are many kinds of symptoms, most of which are localized, such as some people may have symptoms of eyelid collapse, and some are muscle incoordination in other parts of the body. So, what are the manifestations of myasthenia gravis in general? How to ** myasthenia gravis?

1. Symptoms of myasthenia gravis

(1) Spleen and stomach weakness

Drooping eyelids, limb weakness, gradually aggravated, exertion, relieved after rest, fatigue, lack of breath and lazy speech, reduced diet, choking on eating, and even difficulty swallowing. The stool is loose, the face is unpretentious, the tongue is fat, the moss is thin and white, and the pulse is weak.

(2) Liver and kidney yin deficiency type

Drooping eyelids, strabismus or diplopia, weakness of the lower limbs, inability to stand for a long time, even poor mobility, thin muscles, soreness of the waist and spine, tinnitus and confusion. Women have irregular menstruation, men have impotence, hot flashes and night sweats. The tongue is red and less bitter, and the pulses are fine.

(3) Spleen and kidney yang deficiency type

Dropping eyelids or weakness of limbs, or even general weakness, easy fatigue, chills and cold limbs, soreness in the waist and knees, frequent urination or nocturia, loose stools or incomplete grains, pale tongue, tooth marks on the edges, thin white tongue coating, and thin pulse.

(4) Deficiency of qi and blood

Drooping eyelids or general weakness, yellowish or pale complexion, thin limbs, small amount of food, low voice, shortness of breath, dizziness and weakness, irregular menstruation in women, light color, pale tongue, thin white tongue, weak pulse.

Myasthenia gravis is a condition that first manifests in the eyelid area and then throughout the body, and the muscles cannot be controlled. In fact, the symptoms of myasthenia gravis can develop over time into a condition that cannot be controlled by the internal muscles.

2. How to ** myasthenia gravis

Thymus extraction. It is now believed that all patients with generalized myasthenia gravis without surgical contraindications, and even patients with ocular myasthenia gravis who have been ineffective for a long time, regardless of whether they have thymic tumors or thymic hyperplasia, should consider removing the thymus, which is the preferred method of myasthenia gravis now.

Adrenocorticosteroids.

It is suitable for patients with eye shape, cholinesterase effect is not satisfactory and ready for thymectomy, and patients whose condition is deteriorating and do not want to undergo thymus surgery.

Cytotoxic agents. Such as cyclosporin, cyclophosphamide, azathioprine, methotrexate, etc.

Other. Such as traditional Chinese medicine, plasma exchange, thymus radiotherapy, etc.

3. Pay attention to the diet of muscle weakness in chain disease

1. It is recommended to choose more fresh vegetables and fruits, and according to the chewing situation, vegetables and fruits can be made into vegetable puree, fruit puree, vegetable juice, juice, etc.

2. Patients with myasthenia gravis who are easy to choke on food can try viscous liquids, such as thick rice soup and fruit juice to wash lotus root powder, instead of water and drinks.

3. The prepared food should be soft, easy to swallow, easy to chew, and provided in the form of semi-liquid food or soft rice, with a small amount of frequent meals as well.

4. Avoid spicy, warm, dry, and heat-promoting foods, and avoid foods that are raw and cold, have a lot of crude fiber, and are not easy to digest.

5. When cooking, try not to use cooking methods such as frying, baking, boiling, and exploding, and you can choose steaming, boiling, stewing, soup, etc.

Myasthenia gravis affects all skeletal muscles of the whole body, and the clinical Osseman classification is usually performed, with the following manifestations common:

1. Ocular muscle type: the most common eyelid drooping is the basic characteristics of morning and twilight heaviness, but some patients can show twilight and morning heaviness;

2. Systemic type: including dysphagia due to phagial muscle involvement, dysphonia, slurred voice, or even inability to make a voice due to articulatory organ involvement, masticatory muscle weakness manifested as difficulty in chewing, limb muscle weakness makes it difficult to walk, respiratory muscle involvement causes dyspnea or even respiratory failure, and ventilator support is required**.

In the early stage of myasthenia gravis, patients often feel soreness and discomfort in the eyes or limbs or blurred vision, easy to fatigue, in hot weather or menstrual cramps, fatigue will be particularly aggravated, with the development of the disease, the patient's skeletal muscles will be obviously tired and weak, the significant feature is muscle weakness, aggravated after exertion in the afternoon or evening, and can be reduced after getting up or resting in the morning.

Patients with myasthenia gravis can have all the skeletal muscles of the whole body affected, and the following symptoms can occur: 1. Drooping eyelids, blurred vision, diplopia, strabismus, and inflexible eye movement. Second, the expression is indifferent, the face is wry, the speech is large, the articulation is difficult, and it is often accompanied by a nasal voice.

3. Weakness in chewing, choking on drinking water, and difficulty swallowing. Fourth, it is difficult to turn the neck and raise the head, and the neck is turned and the shoulders are weak. Fifth, it is very difficult to raise your arms, comb your hair, go up the stairs, squat down and get on the car.

Myasthenic crisis refers to the sudden deterioration of the condition of patients with myasthenia gravis due to some reason in the course of the disease, and the dyspnea is life-threatening, and the crisis of myasthenia is usually divided into three types according to different reasons: First, myasthenic crisis is mostly caused by the development of the disease itself.

Second, cholinergic crisis, seen in patients taking higher doses of pyridostigmine bromide for a long time. Third, in the anti-crisis crisis, the dose of pyridostigmine bromide did not change, but the drug suddenly became ineffective and severe dyspnea appeared.

Myasthenia gravis is most commonly manifested by severe weakness or even paralysis after continuous muscle contractions, which can be relieved by rest. Muscle weakness is often worse in the afternoon or evening due to exertion and may be relieved in the morning when you wake up or rest. The first symptom of patients with myasthenia gravis is mainly one or both extraocular muscle weakness, such as drooping eyelids, strabismus, diplopia, and in severe cases, the eye movement is completely fixed, and the eye movement is obviously restricted, but the patient's pupillary sphincter is not damaged, and the pupil is not dilated when the patient's pupil is illuminated with a lamp.

In addition, the patient's facial muscles and oropharyngeal muscles are also susceptible to injury, and the patient often shows an indifferent and wry smile, and the patient will have weakness, choking on drinking water, difficulty swallowing, nasal voice when speaking, and dysphonia when chewing continuously during meals. If the sternocleidomastoid or trapezius muscles are damaged, the neck may be soft, the head may be raised, and the patient may not have the strength to turn the neck or shrug the shoulders. On physical examination, the patient's tendon reflexes are often unaffected and the patient feels normal, which is the main manifestation in patients with myasthenia gravis.

After the onset of myasthenia gravis, the body will have a variety of adverse symptoms, the more common ones are drooping eyelids, general weakness, chewing weakness, expressionlessness, slurred speech and neck soreness. Keeping abreast of these symptoms can be of great help to the disease.

Myasthenia gravis is a relatively common disease, although it is very difficult, but it is not an incurable disease, but it must be treated as soon as possible. However, in real life, many people do not understand the symptoms of myasthenia gravis, so that they delay the best time, which has caused serious consequences. So what are the symptoms of myasthenia gravis?

1. Drooping eyelids: drooping eyelids is what we call drooping eyelids, which is one of the most common symptoms of myasthenia gravis. In addition, patients with myasthenia gravis may also have symptoms of not closing their eyes tightly, and there is always a slit in the eye.

2. General weakness: people with myasthenia gravis will also have symptoms of general weakness, after the onset of the disease, patients often have severe general weakness, shoulders can not be lifted, hands can not lift things, once squatting can not stand up, or even no way, normal face washing and combing hair. Generally speaking, the symptoms will improve significantly after resting for a while, but if you can work, the symptoms will worsen again.

3. Weakness in chewing: Weakness in chewing is also one of the main symptoms of myasthenia gravis. Generally speaking, such patients do not have any dental problems, but they can't bite anything, and even eating steamed buns is very difficult.

At the beginning, you can still eat two bites, but in the later stage, you can't bite directly. It is particularly difficult to swallow food, it takes a long time to finish a meal, and it is easy to choke when drinking water, and in severe cases, water will flow out of the nostrils.

4. Expressionless: Many patients with myasthenia gravis will have damaged facial expression muscles, and they will always feel that they are expressionless, and sometimes they will show a wry smile.

5. Slurred speech: When myasthenia gravis occurs, the patient will also have symptoms of slurred speech, unable to speak clearly, unable to express himself fluently, and will have a nasal voice when speaking, and sometimes the tongue cannot be extended.

6. Neck soreness: Neck soreness is also one of the more common symptoms of patients with myasthenia gravis, patients often feel that their heads are very heavy, and it is very difficult to straighten their heads, and they must lower their heads or rest against the wall for a while to get better.