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Myasthenia Gravis

Please help

10/12/2009

Question:

Hi I`m a 35 year old mother who has been having severe neck pain which is eased by supporting my right side of my neck with a pillow whilst sitting in a chair or lying on the bed, i have been having severe headaches which I have been told that are due to a trapped nerve, acheing right arm, dropping utensils held in my right hand due to weekness, shooting pains in hand, neck and head,buzzing in ears balance off especially when i get stressed. I recently had a blood test which showed borderline 6 MG where can i go from here?

Answer:

It sounds very frustrating for you. A positive antibody test is not how you make a diagnosis of myasthenia, it is just how the diagnosis made clinically is supported. First let us define myasthenia gravis; it is a disease of bad communication between the nerves and the muscle, usually because our immune system is attacking that neuromuscular junction. It usually presents as fatiguing weakness of proximal muscles (shoulders, thighs, hips), diplopia (double vision), ptosis (droopy eyelids), and can even present with dysphagia (swallowing problems) and dyspnea (breathing weakness). Fatiguing weakness is a big issue, especially with double vision (not blurry or burning), meaning that it fluctuates during the day (better after rest and worse after exertion). Shooting pains, headaches, neck pains, pain in a limb, and tinnitus are not primary symptoms. Keep working with your physician. Do not forget about safety: if you are having worsening shortness of breath or worsening swallowing difficulties, you need to communicate this to your get yourself to the nearest hospital to be evaluated by medical staff.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati