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Myasthenia Gravis

Lupus and myasthenia gravis

02/14/2008

Question:

I`m a 38 year old female dx with SLE 3 years ago (5`9, 145lb). I have many unresolved neurological issues and my rheumatologist has brought up Myasthenia Gravis a couple of times due to difficulty walking. The antibody test was negative but all of my antibody levels have come down with use of Plaqunil and Prednisone for my lupus, so I don`t know if the drugs would have an impact.

I have the following issues leading my rheumatoglist to still question MG (these started prior to being on prednisone): Extreme leg weakness after being up and about for awhile, I`ll rest, have a difficult time rising from a sitting position, it will take me a moment to get a proper gait and then I can walk normally again but usually for a shorter amount of time than the first. This worsens as the day goes on. I have difficulty climbing stairs and also have issues with my right leg dropping or dragging at times. I have difficulty with arm weakness (most of the time can`t wear a watch or hold something for very long) , I have esophageal dysmotility which causes difficulty with swallowing. I fatigue easily and have a little eye lid dropping then but not normally. I have a lot of speech disturbances and cognitive dysfunction related to frequent and sever atypical migraines w/ aura (often looks like I’m having a stroke). I also have difficulty breathing especially with these episodes or in the evening.

I see neruo specialist for assistance with the atypical migraines which are very debilitating and they say are directly related to the lupus but they say they don’t know what is happening with my walking. I’ve been tested and scanned for most everything. Things seem to get worse over time except when my prednisone does increases, then it is a bit easier to walk and do stairs.

Any advice? I’m know this iscomplicated and don’t expect miracles from anyone.

Answer:

Though there is a chance that you have myasthenia gravis, I can not "diagnose you" over the internet.

Instead, I suggest that you make an appointment to see a neurologists at the nearest Muscular Dystrophy Association (MDA) clinic. They will be able to give you a careful evaluation to see whether or not you have myasthenia gravis. You will find the nearest clinic by going to the web page (mdausa.org) and typing in your ZIP code under finding a clinic.

Take care.

For more information:

Go to the Myasthenia Gravis health topic, where you can:

Response by:

John G Quinlan, MD John G Quinlan, MD
Professor of Neurology
College of Medicine
University of Cincinnati