Specialized Neuromuscular Care

Myasthenia Gravis Management

Comprehensive diagnostic evaluation, immunomodulatory therapies, and long-term stabilization for neuromuscular junction disorders.

Dr. Neeraj Kumar

MBBS, MD (General Medicine), DM (Neurology)

Senior Consultant Neurologist • Neurocare Clinic

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Understanding Myasthenia Gravis

Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular condition characterized by fluctuating weakness and rapid fatigue of voluntary muscles. It occurs when autoantibodies disrupt or destroy acetylcholine receptors (AChR) or related proteins at the neuromuscular junction, interrupting normal nerve-to-muscle transmission.

A hallmark of Myasthenia Gravis is that muscular weakness worsens with sustained activity and noticeably improves following periods of rest. With early neurological intervention, precision antibody testing, and tailored immunosuppressive therapy, patients can achieve durable remission and lead active, productive lives.

Common Clinical Manifestations

Ocular Symptoms

Drooping of one or both eyelids (ptosis) and double vision (diplopia) that typically worsen towards the end of the day or after reading.

Bulbar Weakness

Difficulty chewing solid food, nasal or slurred speech (dysarthria), and impaired swallowing (dysphagia) causing choking episodes.

Limb & Neck Weakness

Weakness affecting the shoulders, arms, hips, and neck muscles, making tasks like combing hair, lifting arms, or holding up the head challenging.

Generalized MG

Progression from ocular manifestations into widespread proximal muscle groups, requiring balanced symptomatic and disease-modifying care.

Diagnostic & Therapeutic Modalities

Electrophysiological Diagnostics: Repetitive Nerve Stimulation (RNS) tests and Single-Fiber EMG (SFEMG) to demonstrate neuromuscular transmission breakdown.
Serological Antibody Profiles: Precise screening for Acetylcholine Receptor Antibodies (AChR-Ab), Muscle-Specific Kinase (MuSK-Ab), and LRP4 markers.
Targeted Pharmacotherapy: Anticholinesterase agents (Pyridostigmine) for rapid symptom relief, combined with corticosteroids and steroid-sparing immunosuppressive agents.
Thymus Imaging & Evaluation: Chest CT/MRI evaluation to screen for thymic hyperplasia or thymoma, guiding thymectomy referral when appropriate.
Acute Exacerbation Protocols: Timely administration of Intravenous Immunoglobulins (IVIg) or Plasma Exchange (PLEX) during severe disease flares.

Emergency Warning: Myasthenic Crisis

A myasthenic crisis is a medical emergency where the respiratory and throat muscles become too weak to support spontaneous breathing or clear secretions. If you or a loved one experiences shortness of breath, severe inability to swallow liquids, or severe breathlessness when lying flat, seek emergency hospital care immediately.

Consult Dr. Neeraj Kumar at Neurocare Clinic

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