Treatment and Prevention
There are four treatments used in myasthenia gravis, and most sufferers
receive more than one of them. They are:
- medications - Anticholinesterase medications like pyridostigmine
and neostigmine control symptoms. Corticosteroids (e.g., prednisone)
and immunosuppressants (e.g., azathioprine) can slow or stop the disease
process. Although these drugs don't cure it, they are the mainstay of long-term
management.
- plasmapheresis - Large amounts of blood are removed, then put in
a centrifuge to separate the red and white cells from the serum, the liquid
that contains the immune antibodies which are doing the damage. The red and
white cells are then replaced, along with donated or synthetic serum.
- immunoglobulin - The fact that this treatment works suggests that
a weakened immune system is part of the cause of myasthenia gravis. Immunoglobulin
therapy involves injections of blood serum from a person without autoimmune
disease. It lowers the numbers of tissue-attacking antibodies in the bloodstream
of the person with myasthenia gravis. A course of injections lasting a few
months can provide permanent relief from symptoms.
- thymectomy - The thymus isn't essential in adults and it can be surgically
removed without negative effects. This cures about two-thirds of people with
myasthenia gravis, whether they have evidence of an abnormal thymus or not.
In fact, the cure rate in myasthenia gravis patients with thymomas (tumors
of the thymus) is about the same as in people with an apparently healthy thymus
or a malfunctioning but non-cancerous thymus. Of the one-third of patients
who aren't cured by this operation, many can reduce their drug dosage afterwards.
Some people diagnosed with myasthenia gravis are diagnosed with thymoma
at the same time. Fortunately, thymomas are slow-growing tumors, and while
they're not actually benign (non-cancerous), they have a low chance of
spreading in any given year. Most thymomas are found while they're still localized
in the thymus, and removing that organ usually provides a complete and lasting
cure for both the myasthenia and the cancer. In fact, myasthenia gravis is often
a lifesaver, because it alerts doctors to a tumor while there's still plenty
of time to do something about it.
Nothing can prevent this disease, since we don't know what causes it. However,
serious complications can be prevented if people with myasthenia gravis go to
the hospital if they ever have difficulty breathing. About one in ten people
with this disease will face a myasthenic crisis at some point.
*All medications have both common (generic) and brand names. The brand name
is what a specific manufacturer calls the product (e.g., Tylenol®).
The common name is the medical name for the medication (e.g., acetaminophen).
A medication may have many brand names, but only one common name. This article
lists medications by their common names. For more information on brand names,
speak with your doctor or pharmacist.