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Wednesday, December 11, 2013
Stem cell therapies are being applied to the treatment of autoimmune diseases. A great deal of study needs to be done before there is common use of the treatment. It is hoped that one day some parts of the findings from stem cell research might be used to help MG patients.
Some women may notice fluctuations in muscle strength during the time of their period, and may benefit from hormone therapy to prevent these fluctuations. However, some women do not notice any changes. I am not aware of any effect of menopause on MG.
There is NO valid information to suggest at present that dental disease is involved in MG. Cyclosporine can cause gingival hyperplasia (overgrowth of the gums). Anesthetics or narcotics used for dental procedures may cause weakness in MG patients but most dental procedures are safe for MG patients to undergo. Most patients also require immunosuppression with steroid drugs and may be more likely to develop dental infections. Mercury in a dental amalgram (fillings) does not cause or worsen the disease. You should always discuss any surgical procedure including dental work with your neurologist.
I always recommend to first try to work with your insurance company. The individual who first answers the phone are saying "no" based on guidelines established by the insurance company. However, all insurance companies have review procedures. Please review your policy statement and see what procedure you need to follow to have your unique situation reviewed. Often, the medical director of the insurance company reviews the case and may decide an expert consultation is appropriate. If this still does not work, you should contact the Myasthenia Gravis Foundation for possible assistance.
In the experience of my patients, most procedures are usually safe for patients with good strength. Sometimes plasma exchange before major surgery to improve strength is a good idea. This may decrease the possibility of requiring breathing support (ventilator) after surgery. Close monitoring of the patient after surgery by the surgeon and neurologist is imperative. Pain control also is an important aspect when having a surgical procedure. Based on the type of surgery, activity such as walking, driving a car or lifting objects may be restricted during the recovery period.
Last Reviewed: Dec 29, 2003
Henry J Kaminski, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University