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When Your Child Has Myasthenia Gravis (MG)

You have been told that your child has myasthenia gravis (MG). This condition causes your child’s muscles to become weak. MG is a serious condition. But it can be managed. With treatment, your child can still live an active and healthy life.Normal open eyes compared with ptosis. Eyes with ptosis appear to be partly shut.

What Causes MG?

MG occurs due to problems with the connections between nerves and muscles. These are called neuromuscular junctions. With MG, the body’s immune system makes abnormal antibodies (disease-fighting substances) that attack at the neuromuscular junction. This keep the nerves from sending signals to the muscles they control. As a result, the muscles do not work properly, which causes weakness.

What Are the Symptoms of MG?

The main symptom of MG is muscle weakness. This muscle weakness can range from mild to severe. Depending on which muscles are affected, MG may cause:

  • Droopy eyelids (ptosis)

  • Weakness of eye movements, which can cause blurred or double vision

  • Weakness in the neck, arms, and legs

  • Trouble speaking

  • Trouble chewing and swallowing

  • Trouble breathing

  • Trouble feeding (only infants)

How Is MG Diagnosed?

Your child will likely be referred to a pediatric neurologist. This is a doctor with special training to find and treat problems that affect the nervous system. The doctor will ask about your child’s health history and symptoms. If your child is an infant, the doctor will also ask about honey intake. The doctor will also examine your child. Your child’s muscle strength will be checked. Skills such as vision, chewing, and swallowing will also be checked. Tests will be done to confirm the problem as well. These can include:

  • A nerve conduction study (NCS). This helps check nerve and muscle function. Electrodes (small round discs attached to wires) are placed on the skin over certain nerves and the muscles they control. A brief electrical current is sent to the nerves. The time it takes for the muscles to respond to the nerves is then recorded.

  • Electromyogram (EMG). This is often done with a nerve conduction study. It also helps checks nerve and muscle function. Small needle electrodes are placed into muscles in the arms or legs. The electrical activity of the muscles is recorded when the muscles are active and when they are at rest. This is the most useful and quickest test for MG.

  • Blood tests. These help check for certain cells or antibodies in the blood that are only present with MG. For these tests, a sample of blood is taken from a vein.

  • Edrophonium test. This test helps check muscle strength. Medication called edrophonium is injected into a vein. If a person has MG, the medication will cause a brief increase in muscle strength. For instance, the person’s eyelids may be less droopy for a short time.

How Is MG Treated?

Treatment for MG will vary for each child. Treatments can include:

  • Medications. These help improve muscle weakness. Some medications treat the problems at the neuromuscular junction. It is important to make sure your child takes the right amount of medication because too much medication can cause a crisis. Others help prevent the immune system from making abnormal antibodies. A common chronic medication is steroids, which have their own side effects.

  • Plasma exchange and high-dose IVIG. These treatments involve the use of special blood products and are done when a child is acutely ill. They help fight the body’s abnormal immune response.

  • Surgery to remove the thymus gland. The thymus gland lies beneath the breastbone. It is involved in the immune system. In a person with MG, the thymus gland is more likely to be enlarged or abnormal. In some cases, removing the gland may improve symptoms or even make them go away. The doctor will tell you more about this treatment, if needed.

What Are the Long-Term Concerns?

MG is a chronic (long-lasting) condition. To help prevent problems, ongoing care is needed. This means your child needs to have regular checkups with the doctor. Your child may also need to take medications daily to help control symptoms. Your child may also be prescribed supportive care, if needed. This can include speech, physical, or occupational therapy.


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