Mya Health Dictionary

Muscular pain... myalgia

A serious disorder in which the chief symptoms are muscular weakness and a special tendency for fatigue to come on rapidly when e?orts are made. The prevalence is around 1 in 30,000. Two-thirds of the patients are women, in whom it develops in early adult life. In men it tends to develop later in life.

It is a classical example of an autoimmune disease (see AUTOIMMUNITY). The body develops ANTIBODIES which interfere with the working of the nerve endings in muscle that are acted on by ACETYLCHOLINE. It is acetylcholine that transmits the nerve impulses to muscles: if this transmission cannot be e?ected, as in myasthenia gravis, then the muscles are unable to contract. Not only the voluntary muscles, but those connected with the acts of swallowing, breathing, and the like, become progressively weaker. Rest and avoidance of undue exertion are necessary, and regular doses of neostigmine bromide, or pyridostigmine, at intervals enable the muscles to be used and in some cases have a curative e?ect. These drugs act by inhibiting the action of cholinesterase – an ENZYME produced in the body which destroys any excess of acetylcholine. In this way they increase the amount of available acetylcholine which compensates for the deleterious e?ect of antibodies on the nerve endings.

The THYMUS GLAND plays the major part in the cause of myasthenia gravis, possibly by being the source of the original acetylcholine receptors to which the antibodies are being formed. Thymectomy (removal of the thymus) is often used in the management of patients with myasthenia gravis. The incidence of remission following thymectomy increases with the number of years after the operation. Complete remission or substantial improvement can be expected in 80 per cent of patients.

The other important aspect in the management of patients with myasthenia gravis is IMMUNOSUPPRESSION. Drugs are now available that suppress antibody production and so reduce the concentration of antibodies to the acetylcholine receptor. The problem is that they not only suppress abnormal antibody production, but also suppress normal antibody production. The main groups of immunosuppressive drugs used in myasthenia gravis are the CORTICOSTEROIDS and AZATHIOPRINE. Improvement following steroids may take several weeks and an initial deterioration is often found during the ?rst week or ten days of treatment. Azathioprine is also e?ective in producing clinical improvement and reducing the antibodies to acetylcholine receptors. These effects occur more slowly than with steroids, and the mean time for an azathioprine remission is nine months.

The Myasthenia Gravis Association, which provides advice and help to sufferers, was created and is supported by myasthenics, their families and friends.... myasthenia gravis

A syndrome in which various combinations of extreme fatiguability, muscle pain, lack of concentration, panic attacks, memory loss and depression occur. Its existence and causes have been the subject of controversy re?ected in the variety of names given to the syndrome: CHRONIC FATIGUE SYNDROME (CFS), post-viral fatigue syndrome, Royal Free disease, epidemic neuromyasthenia and Icelandic disease. ME often follows virus infections of the upper respiratory tract or gut, but it is not clear whether this is an association or cause-ande?ect. It may occur in epidemics or as individual cases. Physical examination shows no evidence of diagnosable disease and there is no diagnostic test – diagnosis usually being made by excluding other possible disorders. The sufferer usually recovers in time, although sometimes recovery may take many months or even years. The most severely affected may be bedridden and may need tube-feeding. There is no speci?c curative treatment, but symptomatic treatment such as resting in the early stages may help. Some experts believe that the illness has a psychological element, and sufferers have been treated with COGNITIVE BEHAVIOUR THERAPY. In 1998 the Chief Medical O?cer set up a multidisciplinary working group, including patients, to consider possible cures and treatments for ME/CFS. The report (2002) concluded that the disorder should be recognised as chronic and treatable, but there was no clear agreement on cause(s) and treatment(s). Meanwhile research continues, including a programme by the Centre of Disease Control in Atlanta, USA. Su?erers may ?nd it helpful to consult the ME Association.... myalgic encephalomyelitis (me)

Also known as (see chronic fatigue syndrome).... myalgic encephalomyelitis

An increase in the number of eosinophils in the blood. May occur in a number of allergies, infections, and is sometimes responsible for leukaemia. Among other causes, food supplement tryptophan has been linked. See entry.

Symptoms. Stiffness and severe muscle pain.

Treatment. Formula. Echinacea 2; Burdock 1; Yarrow 1; Poke root quarter. Dose: Liquid Extracts: 1-2 teaspoons. Tinctures: 2-3 teaspoons. Powders: 750mg (three 00 capsules or half a teaspoon). Thrice daily. ... eosinophilic myalgia syndrome (ems)

Autoimmune disorder. Nerve weakness due to defective nerve impulse transmission. Rare. Neuro-muscular disease with spells of extreme weakness. Sight, voice and breathing are most at risk. Often misdiagnosed as neurosis. Muscles fail to respond to directions from the brain. May be associated with a tumour of the thymus, removal of which is curative.

Symptoms: weakened eye muscles producing drooping eyelids (ptosis). Double vision (diplopia). Weakness of neck muscles served by the cranial nerves. Thymus gland abnormality. Difficult swallowing, chewing, slurred speech, fatigue, ‘simply cannot hold her head up’.

Lid-lag test and Tensilon tests establish diagnosis.

Treatment should give support to the thymus gland.

Alternatives. To improve nerve transmission: but not cure. Ephedra tea BHP (1983). 1 teaspoon to each cup boiling water; infuse 15 minutes, thrice daily.

Formula. Oats 2; Ginseng 1; Sarsaparilla 1; pinch Cayenne or drops Tincture Capsicum. Dose: Liquid Extracts: 1 teaspoon. Tinctures: 2 teaspoons. Powders: 500mg (two 00 capsules or one-third teaspoon). Thrice daily.

Practitioner: Ephedrine.

Diet: Gluten-free. ... myasthenia gravis (mg)