Homoeopathic approach towards myasthenia gravis

Dr Darash Panchal

Abstract:-  This is the most common cause of acutely evolving, fatigable weakness and preferentially affects ocular, facial and bulbar muscles. It is caused by false immune response to acetylcholine receptors which are found in junctions between muscles and the nervous system. Homoeopathy has potential for treating myasthenia gravis by improving muscular weakness and enhances the better life ahead. Alumina, Causticum, Cocculus indicus, Gelsemium, Conium mac, Curare, Plumbum metallicum, Zinc metallicum are  the possible remedies for treating myasthenia gravis.

Keywords:- Myasthenia gravis, homoeopathic approach

Abbreviation:- MG – Myasthenia gravis

Introduction:-
Myasthenia gravis is a chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscles resulting in weakness of the skeletal muscles. It affects the voluntary muscles of the body especially those that control the eyes, mouth, throat and limbs. The disease can strike anyone at any age but is more frequently seen in young women aged 20 and 30, men aged 50 and older.

Cause:-
Myasthenia gravis is an autoimmune disease, most commonly (80% cases) caused by antibodies to acetylcholine receptors in the post-junctional membrane of the neuromuscular junction. Myasthenia gravis is not inherited and it is not contagious. It generally develops later in life when antibodies in the body attack normal receptors on muscle. This blocks a chemical needed to stimulate muscle contraction.

Classification:-
Myasthenia gravis is classified as

1. Acquired autoimmune
2. Neonatal myasthenia gravis
3. Drug induced myasthenia gravis
4. Congenital Myasthenia gravis

Clinical Features:-

• Extra ocular muscle weakness or ptosis is present initially in 50% of patients and occurs during the course of illness in 90%
• The disease remains exclusively ocular in only 16% of patients
• About 87% of patients have generalized disease within 13 months after onset
• Fatigable muscle weakness
• Weakness of occulomotor muscles may mimic a central eye movement disorder
• Intermittent ptosis or diplopia
• Weakness of chewing, swallowing
• Impaired speech
• Facial Expressions are affected
• Weakness in arms and legs but this usually happens in conjunction with muscle weakness in other parts of the body
• Symptoms are usually intermittent
• Symptoms may disappear for weeks may appear again later
• Weakness is typically least severe in the morning and worsens as the day progresses

Complication:-

• Myasthenia crisis is a medical emergency that develops when muscles that control breathing become severely weakened.
• This condition may lead to acute respiratory failure and patients often require a respirator to assist breathing during the crisis.
• Other complications that may develop include choking, food aspiration, and pneumonia.

 Diagnosis:-

• It is not diagnosed easily. Since weakness can happen in any other disease, mild myasthenia gravis is often not diagnosed.
• Blood tests:- These tests look for antibodies that may be present in people with myasthenia gravis.
• Genetic tests:- These tests are done to check for conditions that run in families.
• Nerve conduction studies:- A test called repetitive nerve stimulation is used to diagnose myasthenia gravis.
• Electromyogram (EMG):- A test that measures the electrical activity of a muscle. An EMG can detect abnormal electrical muscle activity due to diseases and neuromuscular conditions.

Homoeopathic Approach:-

Homoeopathy with its holistic approach proves to be one of the most valuable systems of medicine while dealing with the cases of Myasthenia gravis (MG). MG is a constitutional disorder, where the whole constitution. Needs to be addressed. MG is a progressively deteriorating condition, calling for some measures to arrest or control the disease process. Homeopathic treatment being constitutional in nature treats the disease at a deeper level, to achieve the Control of the disease process and symptomatic relief.

Homeopathy has shown its efficacy in reducing the frequency of relapses and improving the power and tone of muscles. The totality includes subjective and objective understanding about the disease state where the underlying cause and the individual’s susceptibility are being addresses.

The indicated homoeopathic medicines are:-

1. Alumina:- Heaviness, staggering and sluggishness with very bad constipation are the characteristics of the remedy. Extremities feel paralyzed; leg feels asleep specially when sitting with legs crossed. Heels feel numb, tenderness in soles, feel soft and swollen. Inability to walk especially when eyes are open or in daytime. Pain in arm and fingers, as if hot iron penetrated.

2. Causticum:- Causticum is a natural medicine for muscle weakness that has great action on muscles and nerves. It works particularly well for muscle weakness in the arms. There is a progressive loss of muscular strength in the arms, which feel weak and lame. Weakness in arms usually is seen to get worse in the night time. A tearing, dull pain in the arms may be present.

3. Cocculus indicus:- Paralytic weakness in muscle. Weakness of cervical muscles cannot support head. Painful stiffness in neck when moving it. Hands feel numb and asleep. Numbness of sloes go to sleep while sitting. Hands and feet become cold after change of position.

4. Gelsemium:-Gelsemium act upon the muscles and motor nerves, weakness of throat, chest, larynx, sphincter, extremities, etc. Muscular weakness. Complete relaxation and prostration. Lack of muscular co-ordination General prostration. Dizziness, drowsiness, dullness, and trembling. Loss of power of muscular control. Excessive trembling and weakness of all limbs.

5. .Conium mac:- Conium Maculatum is a suitable medicine for muscle weakness in the legs attended with their trembling. Loss of muscle power in legs and extreme weakness from walking short distance is present. The person is unable to walk and has a staggering gait. Shooting pain in the legs may arise. Legs feel heavy and weary. Knees also feel weak. Conium Maculatum is also an indicated medicine for paralytic weakness in lower limbs that ascends upwards.

6. Curare:- Weakness of respiratory muscles. Reflex action diminished. Tired pain up and down spine. Arms weak, heavy. Cannot lift the fingers. Weakness of hands and fingers in pianists. Legs tremble; give way in walking.

7. Plumbum met:- Plumbum Met is a natural cure for severe muscle weakness that progresses rapidly. There appears marked debility, weakness, and lameness of the arms. Muscles of the arm lack the power to move. Muscle weakness is severe and progressive. Cramping in the calf muscles may also be present. Plumbum Met is also a prominently indicated medicine for paralysis of limbs along with atrophy (wasting) of the muscles.

8. Zincum metallicum:- Lameness, weakness, trembling and twitching of various muscles. Feet in continued motion; cannot keep still. Transverse pains, especially in upper extremity. Soles of feet sensitive. Steps with entire sole of foot on floor.

Synthesis Repertory
GENERALS – MYASTHENIA GRAVIS: (20) Alum._mtf arg-n._mtf0 Caust._mtf33 con._mtf cupr._mtf0 cur._{mrr1,mtf,mtf0,sne} cytin._sne diph._mtf dub._mtf gels._mrr1 Gink-b._vml3 nat-m._sne Parathyr._jl1,mp1 pic-ac._sne Sarcol-ac._mtf0 sep._mtf Stann._mtf stroph-h._mtf sulph._sne thuj._mtf

Complete Repertory
Clinical; myasthenia gravis: gels

 Conclusion:-
Homeopathic treatment of myasthenia gravis (MG) is based on immune correction. With the help of homeopathic medicines, the faulty immune system can be made to work properly. Homoeopathy with its holistic approach proves to be one of the most valuable systems of medicine while treating the cases of Myasthenia gravis. Homoeopathy has immense potential for dealing Myasthenia gravis by improving muscular weakness and boosts the quality of patient’s life.

References:- 

1. Stanley Davidson, Davidson’s Principles and Practice of Medicine, 23^rd edition, Elsevier Ltd, 2018, (i) p 1141-1143.
2. Munjal Y.P., API Text book of medicine, 10^th edition, Jaypee brothers medical publishers (P) Ltd, 2015, (i) p 2090 (ii) p 2091
3. Boericke W., New manual of homoeopathic materia medica & repertory (with relationship of remedies), fourth reprint edition, December 2015, New Delhi, Indian books & periodicals publishers, (i)p 46 (ii) p 296 (iii) p 659
4. Phatak S.R., Materia medica of homoeopathic medicines, second edition 1999, New Delhi, B jain Publisher(P)LTD, reprint edition 2008, (i) p 323 (ii) p 746
5. Murphy R., Homoeopathic medical Repertory, 3rd revised edition, New Delhi, B jain Publisher(P)LTD, 6th impression 2017, p 1745
6. Sheela Dandge, Dr. Zankhana Desai, Homoeopathic Approach In Myasthenia Gravis,
7. Welling homoeopathy, Treatment of Myasthenia Gravis, https://www.wellinghomeopathy.com/homeopathic-treatment-myasthenia-gravis/
8. Johns Hopkins medicine, Myasthenia Gravis, https://www.hopkinsmedicine.org/health/conditions-and-diseases/myasthenia-gravis/
9. Life force homoeopathy, Myasthenia gravis homoeopathic treatment, https://www.askdrshah.com/myasthenia-gravis.aspx
10. Vikas Sharma, Dr Homoeo, Top Homeopathic Remedies for Muscle Weakness, https://www.drhomeo.com/homeopathic-treatment/homeopathic-medicine-muscle-weakness/

Dr Darash Panchal
Email : darashpanchal20@gmail.com