Myasthenia Gravis: A Systematic Review

Abstract

Myasthenia gravis (MG), a rare disease, is the most common neuromuscular junction problem. It's the quintessential autoimmune disease with ocular, bulbar, respiratory, axial, and limb muscles exhibiting a typical fatigable weakening due to the development of antibodies against the acetylcholine receptor (AChR). Infections, stress, surgeries, thymus gland anomalies, and pharmaceutical side effects can also cause it. Ocular symptoms are initially experienced by most of the sufferers. The majority of the sufferers will go through at least one episode of symptom exacerbation during their illness. The immune system in MG interferes with nerve-muscle communication, causing muscles to become weak and tired quickly. The actual cause is not yet known, but a problem in the thymus gland may be the cause. In a person suffering from this disease, the size of the thymus becomes larger than normal, which is also called thymic hyperplasia. It is more common for women to have early-onset MG (EOMG) than for males to have late-onset MG (LOMG). Merely clinical evidence, encompassing the patients' medical history and physical indications of fluctuating muscle weakness in a specific region, is utilized to diagnose MG. Complementary diagnostic procedures and lab techniques aid in confirming the synaptic dysfunction and characterizing its kind and degree. Early diagnosis and the availability of effective treatments have reduced the burden of severe impairment and high mortality previously associated with MG. Current immunomodulation-based therapies come with side effects brought on by persistent immune suppression. Improved knowledge of this relatively uncommon but curable condition is required among primary carers. The objective of this review is to provide information about MG and to help people recognize its symptoms and start treatment without panic so that the progression of this disease can be stopped and complications can be avoided.

Is the Myasthenia Gravis (MG) the Result of Age and Sex/Gender? A Narrative Review for Identifying Genetic and Epigenetic Biomarkers for a Differential MG Management in Old and Young Women

“…The muscle weakness is related to an impairment of NMJ and can be generalized or localized, involving mainly the extraocular muscles and/or the levator palpebrae muscles. The fluctuant nature of the symptoms may vary in intensity from day to day, or even from hour to hour, and is due to an excessive contraction of affected muscles [19,20,23,24].…”

“…Based on age at onset, MG is classified into two subgroups, as above mentioned, the EOMG and LOMG, with a prevalence in women [23,24]. However, the number of diagnoses of LOMG in both sexes has recently been increasing [23,24].…”

“…Based on age at onset, MG is classified into two subgroups, as above mentioned, the EOMG and LOMG, with a prevalence in women [23,24]. However, the number of diagnoses of LOMG in both sexes has recently been increasing [23,24]. Indeed, the natural history of the disease is influenced by age-related parameters: for example, treatment options in the elderly patients are often hampered by the numerous comorbidities and contraindications [23,24], and LOMG is often burdened by worse prognosis [23,24].…”

“…However, the number of diagnoses of LOMG in both sexes has recently been increasing [23,24]. Indeed, the natural history of the disease is influenced by age-related parameters: for example, treatment options in the elderly patients are often hampered by the numerous comorbidities and contraindications [23,24], and LOMG is often burdened by worse prognosis [23,24]. Thus, the prevalence of LOMG has increased in recent years [25].…”

Disruption of Neuromuscular Junction Following Spinal Cord Injury and Motor Neuron Diseases

“…Visualizing and analyzing the NMJ in rodent models of these disorders is crucial, particularly during the early stages of the disease. The NMJ is also involved in myasthenic disorders such as myasthenia gravis (MG) and is vulnerable to neurotoxins [ 21 , 22 , 23 ]. Additionally, it is known to degrade before axon loss occurs in response to axotomy and is a common feature of aging.…”