Myasthenia Gravis: Background information when reading The Lady's Handbook for Her Mysterious Illness

Myasthenia Gravis

This article relates to The Lady's Handbook for Her Mysterious Illness

In her memoir The Lady's Handbook for Her Mysterious Illness, Sarah Ramey mentions a litany of so-called mysterious illnesses, some of which are widely known—lupus, Lyme disease, chronic fatigue syndrome, multiple sclerosis—and others that may be less familiar to readers. I was surprised to see her mention a relatively unknown condition that happens to affect someone in my family, who was lucky enough to reach a diagnosis and an effective plan for treatment and management, but not without doing a fair amount of the kinds of research and self-advocacy about which Ramey writes. The illness is myasthenia gravis, a disease that affects approximately between 50 and 200 out of every million people.

Myasthenia gravis, or MG, gets its name from the Greek words "mys" (muscle) and "asthenia" (weakness) along with the Latin "gravis" (serious). As the word origins suggest, the condition is characterized by muscle weakness, typically affecting the muscles of the face (especially those around the eyes and mouth) but also, in some cases, affecting the ability to move or walk.

The chronic disease disproportionately affects younger women and older men. Most often, the muscle weakness begins with relatively mild symptoms—droopy eyelids and difficulty talking or swallowing—which worsen after periods of physical activity and improve after rest or sleep. In rare cases, however, the muscle fatigue can develop suddenly and severely, affecting the muscles that allow for respiration and resulting in a so-called myasthenic crisis, requiring the use of a ventilator.

Like many of the other conditions Ramey touches on, MG is an autoimmune disease, in which the body develops antibodies that disrupt the pathways between neurotransmitters and receptors, preventing muscles from contracting. In many cases, there seems to be a link between an overactive thymus gland and the development of the antibodies that trigger MG.

Although MG is not directly hereditary, it may appear more often in families where individuals have other autoimmune disorders. Mothers with MG can transfer their antibodies to their fetuses, resulting in symptoms of MG in the newborns, though the effects are usually temporary. As a result, women with MG who become pregnant usually require additional monitoring, as might their newborn babies.

There is no real cure for MG, though for most patients, the disease can be adequately managed through a combination of medicine, intravenous therapy for flareups and, in some cases, surgery to remove the thymus. As Ramey suggests in her illness memoir, patients with MG can access a variety of online and in-person support groups to help with sharing information and providing emotional support, making this chronic condition seem less frightening and more manageable.

Patient with myasthenia gravis from an article by physicians William Campbell Posey and William Spiller (1904)

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This "beyond the book article" relates to The Lady's Handbook for Her Mysterious Illness. It originally ran in April 2020 and has been updated for the May 2021 paperback edition. Go to magazine.

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