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IT IS A NOVOMUSCULAR DISEASE TREATED IN TURKEY HOSPITALS
1- What is Myasthenia Gravis?
It gives symptoms such as double and blurred vision, low eyelid, weakness in the hands and arms. It is most common in young women and older men. Myasthenia Gravis, an autoimmune disease, is hardly known in society…
ISU MedicalPark Hospital Istanbul Center Thoracic Surgery Specialist Prof. Dr. answered my questions about both the disease and treatment promote methods.
2- What kind of disease is Myasthenia Gravis?
It is a Novomuscular disease, that is, it affects the muscles and the nerves that control them. It is caused by an autoimmune disorder due to the formation of antibodies that develop against acetyl choline receptors at the junction where the nerves connect to the muscles.
The immune system is the body’s natural defense against diseases. Normally, when bacteria or other foreign substances enter the body, the immune system produces molecules called antibodies that attack the bacteria. In people with Myasthenia Gravis, the immune system produces abnormal antibodies that prevent muscles from receiving signals from nerves that stimulate when they will relax or contract.
3- What symptoms does this condition cause in people?
May cause symptoms including double vision or blurred vision (eye muscle weakness), low eyelid (eyelid muscle weakness), difficulty speaking and swallowing (throat muscle weakness), weakness of the hand and arm muscles, i.e. muscle weakness. This weakness manifests itself more later in the day, fatigue decreases with rest.
4- Who does it affect the most?
It is most common in young women and older men, but it can also occur in people of any age or both sexes. Although it is not known exactly what triggers the autoimmune reaction in Myasthenia Gravis, it is known that the thymus gland plays a role in the disease.
The thymus gland is a small gland located in the front part of the chest, behind the frontal bone of the chest and extending to the lower part of the neck. At the beginning of life, the immune system is the most important organ in the early stage of development. The weight of a baby’s thymus gland is between 0.7-1.1 kg. The function of the thymus gland is considered to be completed by puberty, and then it shrinks.
In older people, the thymus drops by 0.1-0.5 grams. Tumors of the thymus gland are called thymomas. About 10 to 15 percent of people with myasthenia gravis have thymoma. However, there are also other abnormalities, such as thymic hyperplasia in the 60th of the face.
5- How does he get a diagnosis?
The treatment of the disease begins with the correct diagnosis. The evaluation is usually performed by a neurologist. To distinguish it from other muscle and nerve diseases, tests are performed that include blood tests, nerve conduction tests, and the administration of certain medications. After the diagnosis is confirmed, a treatment plan should be made in order to reduce the number of antibodies that cause the disease and/or improve communication between nerve and decongestant.
6- Which ways are followed in the treatment?
The aim of the treatment is to increase muscle strength. There are drug and surgical treatment of myasthenia gravis. In the surgical treatment in which the thymectomy method is applied, the thymus gland is removed. The purpose of a thymectomy is to provide improvement of symptoms by eliminating the source of abnormal antibody production that causes the disease. The benefits of thymectomy are not noticed immediately after surgery, so patients continue with the medication they are using. Over time, the dose of these drugs may be reduced or the drug may be discontinued.
The individual response to thymectomy varies depending on the patient’s age, response to previous medical treatment, the severity and duration of the disease. In general, 70 percent of patients experience complete remission or a significant reduction in drug needs within a year after the procedure. The other 30 percent of patients with thymectomy do not see any changes in symptoms.
According to the American Association of Neurologists, patients who undergo a thymectomy are twice as likely to recover than those who receive medical treatment alone. Thymectomy is recommended for all thymoma patients and patients under the age of 60 with mild to moderate muscle weakness due to myasthenia gravis. It is usually not used only in the treatment of patients whose eyes are affected.
Thymectomy is more effective when performed six to 12 months after the onset of symptoms. The procedure is performed with minimally invasive techniques. Video-Assisted Thoracoscopic Thymectomy (VATS) and Robotic Thymectomy (RATS) methods are performed.
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