Myasthenia Gravis vs Multiple Sclerosis: Unraveling the Parallels and Distinctions

Both, Myasthenia gravis and multiple sclerosis are autoimmune conditions, which means they are caused by an overactive immune system. In both cases, the immune system attacks healthy parts of the body. However, the parts of the body that are attacked by the immune system are different in both these conditions. ^{(1, 2)}

Myasthenia gravis and multiple sclerosis can cause some similar symptoms. ^{(1, 2)} Some of the similar symptoms include:

• Blurry or double-vision
• Weakness in arms, legs
• Difficulty walking

However, both these conditions have some other symptoms that are quite different from each other.

• One more similarity between myasthenia gravis and multiple sclerosis is that there is no single proven factor that exactly causes either of these conditions.
• Additionally, both these conditions often affect people below 40 years of age and are more common in females.
• Both, myasthenia gravis and multiple sclerosis can be triggered by viral infections or other environmental risk factors.
• Although, both these conditions are typically treated differently, both might be treated with steroids. ^{(1, 2)}

Myasthenia gravis (MG) is prevalent across all racial and ethnic groups.⁽³⁾ Females and males are affected equally by the condition. However, in most cases, females under 40 years of age and males over 60 years of age typically develop the condition.

Multiple sclerosis (MS) also affects people of all races and ethnic groups. However, white people and those of European descent most commonly suffer from this condition. Most cases of MS are diagnosed between the ages of 20 and 50, but children and older adults can also be diagnosed with multiple sclerosis. This condition is three times as common in females as it is in males.⁽⁴⁾

The main indicator of Myasthenia gravis is a weakness of the body’s voluntary muscles, which worsens after physical activity and improves after proper rest.⁽⁵⁾ Symptoms of myasthenia gravis include:

• Weakness of the eye muscles.
• Double or blurred vision.
• Eyelid drooping
• Difficulty speaking.
• Problems with swallowing.
• Shortness of breathing.
• Weakness of limbs and neck.

The symptoms of multiple sclerosis widely vary from one person to another, and this changes over time. These symptoms of multiple sclerosis might disappear and reappear.⁽⁶⁾  Some common symptoms of MS include:

• Problems with vision, including blurred and double vision.
• Muscle spasms, tremors, coordination issues, and electric shock sensations.
• Numbness or weakness in one side or the bottom half of the body.
• Fatigue and dizziness.
• Memory problems.
• Loss of bowel or bladder control.
• Sexual dysfunction.

Both myasthenia gravis and multiple sclerosis might involve a combination of genetic and environmental causes, but the exact causes of the two differ from each other.

An enlarged thymus gland could be one of the indicators for the development of myasthenia gravis.

According to the National Organization for Rare Disorders, it has been mentioned that most individuals with myasthenia gravis have no family history of the disease. However, around 5% of individuals with the condition have a relative who also has myasthenia gravis or another autoimmune disorder.⁽⁷⁾

The exact cause of multiple sclerosis is still unknown. However, genetic factors, environmental factors, and certain infectious factors are likely to play a major role in its development.

Individuals with a family history of multiple sclerosis are likely to develop the condition. This suggests a possible genetic link. Some environmental factors like smoking, obesity, and vitamin D deficiency could increase the risk of multiple sclerosis. There is also a possible link between some childhood viruses and the development of the condition in later life.

Doctors conduct a comprehensive medical history and ask about the symptoms experienced by the patients with myasthenia gravis.⁽⁸⁾ A neurological examination will also be performed by the doctor to check for muscle strength, muscle coordination, and problems with eye movements.

Apart from all these, some other tests would also be performed. These tests include:

• Electrodiagnostics: This test involves repeatedly stimulating the nerves with small pulses of electricity. It helps in testing muscle fiber response.
• Blood Tests: Blood tests check the presence of antibodies associated with myasthenia gravis.
• MRI and CT Scans: MRI and CT scans help in detecting problems with the thymus gland.

A comprehensive medical history is conducted to diagnose multiple sclerosis and the doctor asks about the current symptoms the person might be experiencing.

The doctor will also perform a complete neurological examination to check neurologic functions like reflexes, balance, facial function, walking, coordination, hearing, vision, and swallowing.

Some other tests might include:

• Blood Tests: These tests help rule out other underlying conditions.
• MRI Scans: Any damage to the myelin sheath can be identified in MRI scans.
• Lumbar Puncture: This involves removing some cerebrospinal fluid and analyzing it to check for the disease of the central nervous system.

Myasthenia gravis and multiple sclerosis involve different disease mechanisms and show different symptoms. Thus, both these conditions require different treatments. Let us see the differences between their treatment methods.

A combination of medication, surgery, and other treatment approaches to support the immune system are used in treating myasthenia gravis.⁽⁹⁾ Currently, there is no proper cure for myasthenia gravis, so treatment for this condition focuses on strengthening the affected muscles to improve muscle function.

Below are some treatment methods available for myasthenia gravis.

Medications: Anticholinesterase medications, steroids, and immunosuppressants are some medications for myasthenia gravis.

Thymectomy: This is the surgical procedure that involves the removal of the thymus gland, which is involved in the function of the immune system.

Plasmapheresis: In this procedure, the abnormal antibodies from the blood are removed and normal antibodies from donated blood are replaced.

Immunoglobulin Treatment: This involves boosting the level of “immunoglobulin” in the blood, which reduces the tendency of the immune system to attack the nerves.

Multiple sclerosis cannot be completely cured. However, the treatment for this condition primarily focuses on managing the symptoms and slowing disease progression. Some of the treatment methods for MS include:

Medications: Medications, such as interferons, natalizumab, fingolimod, and steroids are beneficial in symptom management of multiple sclerosis.

Complementary Therapies: Physiotherapy, occupational therapy, and speech therapy are some complementary therapies available for multiple sclerosis.

With appropriate treatment, myasthenia gravis improves. Medications can help with the functioning of the immune system and neuromuscular communication. The disease can go into remission, but this will only be temporary.

The symptoms of multiple sclerosis vary widely from one person to another and the symptoms change over time.⁽¹⁰⁾ Symptoms may go into remission and disappear or may recur over time. Most patients with multiple sclerosis can suffer from relapses, when symptoms flare up for 24 hours or longer, and then abate.

Myasthenia gravis and multiple sclerosis are both auto-immune disorders that cause certain similar symptoms. However, they differ from each other in various ways. The underlying causes differ in both cases and so as the diagnosis and treatment procedure.

For both cases, appropriate diagnosis and prompt treatment are essential to help improve the overall quality of life in the affected individuals.

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Also Read:

• Myasthenia Gravis: Causes, Signs, Symptoms, Investigations, Treatment- Medications, Surgery
• How Do You Get Myasthenia Gravis?
• Can Myasthenia Gravis Go Away On Its Own?
• Recovery Period For Myasthenia Gravis
• Multiple Sclerosis (MS) or Disseminated Sclerosis: Types, Risk Factors, Symptoms, Treatment
• Remedies to Combat Constipation In Multiple Sclerosis (MS)
• What Kind Of Pain Does Multiple Sclerosis Cause?
• How Do You Get Multiple Sclerosis?