Generalized Myasthenia Gravis Management: Evaluating Long-Term Effects

Announcer:
Welcome to NeuroFrontiers on ReachMD. On this episode, we’ll learn about the long-term effects of generalized myasthenia gravis, or gMG, with Dr. Maxwell Levy. Dr. Levy is an Assistant Professor of Neurology and the Residency Program Director at Tulane University in Louisiana. Let’s hear from him now.

Dr. Levy:
So there are a lot of different comorbidities that you see in patients with generalized myasthenia gravis, and they can really influence the patient and how their disease progresses. The most common things that you’ll see, aside from the frank muscular weakness, are often going to be side effects of the medications. You’re going to see things like hypertension, diabetes, and osteoporosis with prednisone. You can have fractures, and those really can impact the patient’s mobility. The ability of a patient that has myasthenia to tolerate exercise, participate in physical therapy, and recover from a fracture is really impaired compared to a patient that just has a fracture and does not have myasthenia or another secondary neuromuscular disorder overlaid on top of it.

With the progression of weakness, you can see things affected other than your frank external muscular strength. It’s going to affect the strength of the diaphragm and breathing over time. Especially if patients are poorly controlled, or as their disease progresses and more of their weakness becomes baked in due to the myopathic destructive immune changes and not just the blockading immune changes, they may need more respiratory support. They may have permanent changes in their dietary consistency. We think about myasthenia as a condition of reversible fatigable weakness, but the immune attack on the muscles does cause consistent permanent changes that don’t always remit with rest, and those can be really disabling to patients over time.

Announcer:
That was Dr. Maxwell Levy discussing the disabling impacts of generalized myasthenia gravis on patients over time. To access this and other episodes in our series, visit NeuroFrontiers on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!