Neurology Review: A Quick Rundown of Myasthenia Gravis and ALS

In this neurology review, we’ll be determining what myasthenia gravis and ALS is.

Myasthenia Gravis (MG)

This condition affects the functions of the peripheral nervous system and not the central nervous system which is composed of the brain and spinal cord. The peripheral nervous system is mostly comprised of the muscles and nerves that control the lungs and body movement.

Trivia: Walt Disney created the dwarf, Sleepy, who is a character from Snow White and the Seven Dwarves as a tribute to one of his good friends who has had myasthenia gravis.

And Sleepy’s character is an accurate representation of people who have myasthenia gravis because this condition is manifested as severe muscle weakness that can affect the eyes (droopiness), the lungs, the face, and the throat.

Acetylcholine

The major factor that is affected in myasthenia gravis is a chemical called acetylcholine. Acetylcholine is a potent neurotransmitter that helps the neurons to communicate and thereby, creating a normal body reaction. Due to ineffective secretion of acetylcholine, the body can develop myasthenia gravis.

Signs and Symptoms

People who have myasthenia gravis would appear like gravity is making a huge pull on parts of the client’s body, specifically on the face. The apparent signs and symptoms are:

• Drooping of the eyelids
• Difficulty swallowing and chewing
• Muscle weakness
• Airway and diaphragm issues.

Since difficulty swallowing is included in the manifestations, as a nurse, you have to watch out for aspiration precautions; which is always a huge factor when answering a myasthenia gravis question in your major exams.

Myasthenia gravis is not a progressive disease and mostly occurs due to some triggering factors which would prompt this response.

Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) is also known as Lou Gehrig’s disease. This condition is considered as the worst neurological disease that a person can get. Why? For the following reasons:

• ALS is incurable.
• ALS has no remissions.
• ALS is depressing.
• ALS clients have a life expectancy of about three to five years.

A Prisoner of Your Own Body

The scary part about having ALS is that it’s a disease which makes the client feel like a prisoner of his or her own body. This is because, with ALS, the motor neurons become sclerotic and stiff. While the sensory neurons are still intact and you still think and feel normally, your body cannot move due to motor neuron destruction.

The 3 D’s of ALS

To easily distinguish ALS from the other neurological diseases, you have to remember the three D’s, namely:

• Dysarthria – difficulty moving
• Dysphagia – difficulty swallowing
• Drooling

Complications Leading to Death

As mentioned, ALS affects the motor neurons as they become sclerotic and stiff. Though the brain is still functioning and the senses are still intact, the motor functions are compromised to the point of uselessness. ALS is quite a depressing condition because, aside from feeling trapped in their bodies, clients are also given a life sentence of three to five years.

The progression of this disease will eventually create a domino effect of complications like lung dysfunction and infection, and clients are required to go on a vent to facilitate mechanical breathing.  

Clients with ALS don’t die from the disease itself but from the failure of organs to perform their responsibilities.

So, what are some goals for nurses in taking care of the client with neurological diseases? We’ll get into that on our next lecture. So, check it out on our SimpleNursing website or YouTube channel.