Ohio State’s Myasthenia Gravis Clinic has a broad range of experience to ensure that if you have an uncommon or complicated condition, we can provide the answers and the care you need.

Myasthenia gravis is a disease that causes weakness in the muscles under your control. It happens because of a problem in communication between your motor nerves and muscles. Myasthenia gravis is an autoimmune disease that occurs when your body's immune system makes antibodies that block or change some of the nerve signals to your muscles. This makes your muscles weak, especially with repetitive use.

Common symptoms are trouble with eye movement, double vision, droopy eyelids, facial weakness and trouble speaking and swallowing. It also can affect the muscles in the arms and legs, resulting in fatigue and weakness when walking, going up and down stairs, and getting up out of chairs.  The weakness gets worse with activity and better with rest.

There are medicines to help improve the nerve-to-muscle signaling that makes muscles stronger. With treatment, the muscle weakness often gets much better. Other drugs keep your body from making so many abnormal antibodies. There are also treatments that filter abnormal antibodies from the blood or add healthy antibodies from donated blood. Sometimes surgery to take out the thymus gland helps.

For some people, myasthenia gravis can go into remission and they do not need medicines. The remission can be temporary or permanent.

If you have myasthenia gravis, it is important to follow your treatment plan. If you do, you can expect your life to be normal or close to it.

Source: NIH: National Institute of Neurological Disorders and Stroke

Why choose Ohio State for treatment of myasthenia gravis?

Diagnostic Expertise: Our Myasthenia Gravis Clinic at The Ohio State University Wexner Medical Center has nine neurologists board-certified and fellowship-trained in neuromuscular diseases, including four who specialize in myasthenia gravis.

As one of the largest neuromuscular centers in the country, we see all major categories of neuromuscular disease. Our broad range of experience helps ensure that if you have an uncommon or complicated case of myasthenia gravis, we can provide the answers and the care you need.

Access to National Expertise: When you come to Ohio State, you have a whole consortium of medical centers working on your disease. Our participation on the National Myasthenia Gravis Medical/Scientific Advisory Board connects us with other medical professionals throughout the world who are dedicated to myasthenia gravis clinical care and research. Our patients benefit from this direct knowledge of the latest findings in the diagnosis and treatment of myasthenia gravis and our access to the latest clinical trials.

Research: Our Myasthenia Gravis Clinic offers you the opportunity to enroll in cutting-edge basic science research and clinical trials that are available at only a handful of centers across the country. In addition, our collaboration with national research and clinical trial programs provides us with access to more knowledge and stronger expertise in treating unusual and difficult symptoms.


Dr. Miriam Freimer, director of the Myasthenia Gravis Clinic, discusses the various types of immune-mediated, or autoimmune, diseases and if they are hereditary disorders.

Diagnosis

Diagnosing Myasthenia Gravis

In addition to performing a thorough history and physical exam, your neurologist at Ohio State will recommend some or all of these steps:

  • Single-fiber electromyography (EMG), a highly sensitive tool that uses electronic impulses to evaluate how well the nerve and muscle communicate — few other centers in Ohio offer this test
  • Pulmonary function tests, conducted by a respiratory therapist to determine whether the disease is affecting your ability to breathe
  • Muscle strength test
  • Repetitive nerve stimulation to determine if muscles fatigue rapidly
  • Imaging tests, including computed tomography (CT) or magnetic resonance imaging (MRI)
  • Blood tests

Treatment

Treating Myasthenia Gravis

Our neurologists have treated hundreds of patients with myasthenia gravis and are skilled at recommending treatments that will serve you best.

Treatments include:

  • Medication – Medications can treat various aspects of myasthenia gravis. Some can strengthen muscles. Others prevent abnormal antibodies from developing, filter antibodies from the blood or add healthy antibodies.
  • Surgery – Some patients benefit from surgery to remove the thymus gland (thymectomy) if tumors are present, or if we believe it will help improve strength and decrease the need for medication. We have cardiothoracic surgeons particularly skilled in thymectomy, a procedure not commonly performed. Our expertise and experience help ensure better outcomes.

Infusion Center

Infusion Center

Infusion therapy involves the administration of medication through a needle or catheter. It is provided to patients for treating a wide assortment of often chronic and sometimes rare diseases for which “specialty” infusion medications are effective. Because our Myasthenia Gravis Clinic has its own infusion center, we can schedule your infusion treatment as part of your clinic visit, and your own physician can keep close tabs on you during your treatments.

  • Plasmapheresis (plasma exchange) – We take your blood and separate the blood cells and plasma. Your blood cells are then mixed with a new solution and returned to your body. This removes from your system the antibodies causing the disease and results in improved strength.
  • Intravenous immunoglobulin – This treatment floods your system with good antibodies to minimize the effect of bad antibodies that are causing symptoms.

Research

Research

Ohio State initiates clinical trials, participates in trials collaboratively with other institutions (including Nationwide Children’s Hospital in Columbus on genetics clinical trials) and networks with other centers around the world to offer you the most effective treatment.

We are a member of the National Institutes of Health’s NeuroNEXT: Network for Excellence in Neuroscience Clinical Trials.This collaboration results in more promising treatments, more rapidly, providing patients like you more hope.


Enroll in a clinical trial


Clinical Trials

Researchers at Ohio State are conducting clinical trials to test new medications and to use existing medications in different ways to treat myasthenia gravis. Two of the drugs we are studying are approved for other uses. Both medications target certain segments of the immune system rather than suppressing the entire immune system.

This offers great potential to more effectively treat your myasthenia gravis while limiting side effects that occur with suppressing all of the immune system. 

Eculizumab

The medication eculizumab (Alexion Pharmaceuticals) directly attacks elements of the immune system that cause myasthenia gravis. We are evaluating whether the medication has a significant effect on improving symptoms for patients who have not responded well to other therapies.

Ritixumab

This NIH-sponsored NeuroNEXT study is a placebo-controlled study to test the ability of ritixumab to affect the B cells that are causing the disease. This medication also could have a significant effect on improving symptoms for patients with difficult-to-treat myasthenia gravis.

Belimumab

The purpose of this study is to better understand the side effects of belimumab when given with other lupus medicines. This study mainly focuses on side effects that are not that common or may only be seen with long-term treatment.
Our Doctors

Additional Information

Please bring to your first appointment all records, written reports and lab results from neurologists or referring physicians, as well as a CD of MRI and other imaging results. Also prepare a written family history of neurological diseases for our discussion during your visit.

Preparing for your visit

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