Myasthenia Gravis: Understanding Its Disabling Effects and Treatment Options

Myasthenia Gravis: A Potentially Disabling Autoimmune Disorder

Myasthenia gravis (MG) is a chronic autoimmune disease that impacts nerve impulses to the muscles, causing debilitating and potentially life-threatening muscle weakness.

While many people with MG can manage their symptoms and live full lives, it's also one of the most common autoimmune disorders causing disability.

Understanding the connection between MG and disability can help patients get the treatment and lifestyle support they need.

What is Myasthenia Gravis?

Myasthenia gravis is caused by an antibody attack against acetylcholine receptors in the muscles. This prevents proper nerve signals from reaching the muscles, resulting in weakness and rapid fatigue.

MG most often affects the eye muscles as well as those involved in chewing, swallowing, coughing, and facial expressions. With time, it can impact the arms, legs, neck, and respiratory system.

Symptoms may come and go but tend to worsen with activity and improve with rest. Some common signs include:

• Drooping eyelids
• Double or blurred vision
• Difficulty speaking clearly
• Chewing and swallowing problems
• Unstable or wobbly gait

What Causes Myasthenia Gravis?

While the exact cause remains unknown, researchers believe genetics and environmental factors contribute to MG development. The thymus gland also seems to play a role.

MG is more common in women under 40 and men over 60. Having other autoimmune diseases increases risk as well.

Types of Myasthenia Gravis

There are several classifications of MG that determine severity and treatment approach:

• Ocular MG - Only the eye muscles are affected.
• Generalized MG - Broader muscle weakness.
• Congenital MG - Present at birth.
• Transient MG - Temporary after an infection.

Myasthenia Gravis and Disability

For those with moderate to severe MG, the disorder can greatly impact daily function and independence, making disability accommodation necessary.

Muscle Weakness and Fatigue

The hallmark symptom of MG is progressive muscle weakness that increases with activity and improves with rest. This can make it very difficult to carry out daily tasks.

Simple activities like brushing your hair, getting dressed, or doing household chores may quickly exhaust an MG patient. Even walking across a room or sitting upright can become challenging.

Bulbar Symptoms

Bulbar symptoms like slurred speech, difficulty chewing and swallowing, and facial weakness can also be profoundly disabling.

This makes it hard to communicate, eat meals, take oral medications, maintain oral hygiene, and more. Food or saliva may fall out of the mouth when eating or talking.

Breathing Difficulties

In more severe cases, the muscles involved in breathing and coughing weaken. This can cause respiratory crises where emergency intervention is required.

Even mild breathing impairment can make physical exertion very difficult, limiting activity tolerance.

Vision Changes

Blurred, double vision and drooping eyelids are common ocular symptoms. This can impair reading, driving, depth perception, and other tasks relying on vision.

Unsteady Mobility

Leg weakness, balance issues, and reduced coordination increase the risk of falls and impact the ability to walk independently.

This makes getting around safely difficult without the use of a cane, walker, or wheelchair.

Receiving Social Security Disability for MG

Due to the disabling effects myasthenia can have, many patients pursuing Social Security Disability benefits are approved, especially if symptoms are severe or impact multiple body systems.

Qualifying as Medically Disabled

To receive SSDI or SSI disability benefits, your MG symptoms must prevent you from being able to work and earn income at a substantial level.

Factors like your medical history, test results, treatment response, and doctor evaluations will be used to assess disability status.

Steps to Apply

Applying for Social Security disability with MG involves:

1. Establishing a detailed history of symptom onset and progression.
2. Providing medical records from neurologists and other treating physicians.
3. Undergoing any additional testing or exams requested.
4. Completing self-reported questionnaires about your limitations.
5. Attending any hearings with an SSDI lawyer if initially denied.

Approval Rates

Approval rates for MG disability vary based on severity. Mild cases may be denied while severe, generalized MG has a higher chance of allowance on the initial application or following appeal hearings.

Having adequate medical documentation and legal representation also improves the likelihood of being awarded benefits.

Accommodating Disability at Work

Some people with mild to moderate MG can continue working with certain accommodations. Under the Americans with Disabilities Act, employers must provide reasonable support.

Work Environment Adjustments

Modifying the work environment can help compensate for MG limitations:

• Sit-stand desks to alternate positions
• Space for mobility aids like wheelchairs
• Accessible building entryways
• Close parking spaces
• Well-lit spaces to aid vision

Schedule Flexibility

Adjusting work hours and duties is often essential. Options include:

• Reduced or part-time hours
• Extended breaks to rest
• Modification of physically demanding tasks
• Medical leave when symptoms flare

Assistive Technology

Equipping workstations with assistive devices can also help compensate for certain limitations:

• Voice recognition software
• Text-to-speech readers
• Tools for grasping and writing
• Communication aids
• Specialized screens or magnifiers

At Home Disability Accommodations

Adapting your home environment enables greater safety, access, and independence for those with MG-related disability.

Living Space Modifications

Adjustments like installing ramps, grip bars, and stair lifts can make a home more accessible for those with mobility impairments.

Creating ground floor bedrooms and bathrooms also minimizes stairs.

Assistive Equipment

Equipping spaces with disability aids like shower benches, grabber tools, dressing sticks, and adaptive cooking devices supports daily function.

Power mobility equipment like scooters improves access outside the home when needed.

Smart Home Technology

Smart home systems that allow voice activated control of lighting, doors, appliances, and electronics reduce the need for physical exertion.

Remote monitoring systems provide safety oversight as well.

Coping With MG Fatigue and Weakness

Adapting one's lifestyle is essential to conserve energy reserves and prevent symptom exacerbation when living with MG.

Energy Conservation Techniques

Pacing activities, clustering tasks, planning proper rest periods, and avoiding overexertion prevents fatigue.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.