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Thursday, December 12, 2013
Patients are defined as being in remission if they have no symptoms, their examination is normal (or showing no abnormalities consistent with Myasthenia Gravis), and they are taking no medications for at least 6 months. The nerve-muscle communication point can "heal itself" after the immune system is stopped from attacking it. Experts in MG are always careful to say patients are in remission (and not cured) because once MG occurs, there is a chance that a patient in remission can develop symptoms again in the future. The longer a person remains in remission, the less likely it is that the disease will recur. It is rare for patients to have a recurrence after decades of remission. There is some data that suggest that children who go into remission are more likely to stay in remission. It is possible for a patient to go into remission more than once, however, multiple remissions suggest to me that a patient was never truly in remission to begin with.
Some patients may have a spontaneous remission (no treatment given). 80% remission rates are quoted in studies of patients who have received medications, like Prednisone. Patients may ultimately go into remission with Imuran or cyclosporine treatment. In these cases, they are treated with these medications, stop taking them, and then go into remission.
There is no cure for Myasthenia Gravis and that is why doctors use the term "remission" in describing a resolution of symptoms in a patient no longer needing medications. A thymectomy is thought to increase the chance of remission, but again is not a cure. The immune system is extremely complex in regards to how autoimmune disorders are triggered. A trigger could occur that restarts the autoimmune attack of MG in a patient in remission.
As of yet there is no cure, but with research being done around the world, there is hope that a cure can be achieved.
Patients with Myasthenia Gravis may qualify for disability payments while treatment is first initiated and during exacerbations. Fortunately, most patients improve with treatment and many are able to return to full-time employment, perhaps with some restrictions. The level of weakness and the type of job have great influence on this. Maintaining employment also has psychological benefits.
Myasthenia Gravis is not a progressive or terminal disorder. There are numerous treatments that lead ultimately to significant improvement in strength. There are patients who become very ill and the disorder may take weeks to months to improve, but treatment, in my opinion, will always lead to improvement. Recent studies have indicated that MG patients have no reduction in life span. The majority of MG patients with proper treatment return to a normal functioning life. Death from Myasthenia Gravis is near zero because of modern treatments and intensive care units.
The Myasthenia Gravis Foundation of America organizes support groups. Contact your local chapter or national organization.
Last Reviewed: Dec 29, 2003
Henry J Kaminski, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University