Myasthenia gravis (MG) is a complex, autoimmune disorder in which antibodies destroy neuromuscular connections. This causes problems with the nerves that communicate with muscles, resulting in weakness of the skeletal muscles. MG affects the voluntary muscles of the body, especially the eyes, mouth, throat, and limbs.
Myasthenia gravis is not inherited as a rare genetic disease or contagious, but it may be acquired through immune proteins or antibodies to babies born to mothers with MG, or the disorder may develop spontaneously later in childhood.
There are three types of MG in children, including the following:
The following are the most common symptoms of myasthenia gravis. However, each child may experience symptoms differently. Symptoms may include:
The symptoms of myasthenia gravis may resemble other conditions. Always consult your child's doctor for a diagnosis.
The diagnosis of myasthenia gravis is made after the sudden or gradual onset of specific symptoms and after diagnostic testing. During the physical examination, the doctor obtains a complete medical history of the child, and may also ask if there is a family history of any medical problems.
The mainstay of the diagnosis of MG is through the performance of an electromyogram/merve conduction study (EMG/NCS), which is a test that measures the electrical activity of a muscle or a group of muscles. An EMG/NCS can detect abnormal electrical muscle activity due to diseases and neuromuscluar conditions. The diagnosis of MG is occasionally confirmed with a Tensilon or Edrophonium test. With this test, a small amount of medicine (Tensilon or edrophonium chloride) is injected into the child. If the child has MG, an immediate, but brief, increase in muscle tone is noted.
Other diagnostic tests that may be performed to help confirm the diagnosis of myasthenia gravis include:
Specific treatment for myasthenia gravis will be determined by your child's doctor based on:
There is no cure for MG, but the symptoms can sometimes be controlled. Myasthenia gravis is a lifelong medical condition and the key to medically managing MG is early detection.
The goal of treatment is to prevent respiratory problems and provide adequate nutritional care to the child since the swallowing and breathing muscles are affected by this condition.
Treatment may include:
The extent of the problems is dependent on the severity of the condition and the presence of other problems that could affect the child. In severe cases, a breathing machine may be required to help the child breathe easier.
The health care team educates the family after hospitalization on how to best care for their child at home and outlines specific clinical problems that require immediate medical attention by their doctor. A child with MG requires frequent medical evaluations throughout his or her life.
It is important to allow the child as much independent function and self care, especially with juvenile MG, as possible and to promote age-appropriate activities to ensure a sense of normalcy.
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