Myasthenia gravis (MG) is a disabling and sometimes fatal autoimmune disorder where there is an error in the transmission of nerve impulses sent to the muscles. Currently, there is no cure, but Ayurvedic treatments are efficient to target symptom control.
For normal muscular contraction, the neuro-muscular impulses generated in the motor neurons in the cerebral cortex reach the motor neurons in the spinal cord, and from the motor neurons in the anterior horn cells in the spinal cord, the nerve impulse ultimately reaches the neuromuscular junction (motor endplate). Here, acetylcholine – ACh (neurotransmitter) is released in the synaptic cleft, the space between the nerve terminal and muscle fiber. The released acetylcholine (ACh) then binds with the acetylcholine receptors (AChRs) located in the cell membrane of the muscle fiber, and thus stimulate the local cell membrane.
The stimulation is called end plate potential. From the endplate potential, the impulse spreads across the muscle fiber. This is called the action potential. This action potential results in the contraction of the muscle fiber. The released acetylcholine (ACh) is instantly destroyed by an enzyme, called – acetylcholinesterase. If not done so, the released acetylcholine (ACh) will keep on stimulating the muscle fiber for a long time, which is not desirable. On the other hand, if the released acetylcholine (ACh) does not get the acetylcholine receptors (AChRs) to bind, it will not be able to bring about its desired action.
Autoimmune dysfunction due to Auto Toxins (Ama Visha)
The immune cells (T and B lymphocytes) produce autoantibodies against the acetylcholine receptors (AChRs), and destroy the same. That results in the reduced number of the total acetylcholine receptors (AChRs). Or, alternately, the auto-antibodies may attack the MuSK (muscle-specific kinase), a protein located on the cell membrane of the muscle cell, and thus prevent the muscle fiber from contraction.
In such a situation, because of the lack of the acetylcholine receptors (AChRs), the acetylcholine released in the synaptic cleft will not be able to act, with the result that the muscle fiber will not contract. This situation manifests as fatigue and muscle weakness, the two key symptoms of myasthenia gravis known as वातक्षयज मांसपेशी-दौर्बल्य in Ayurveda.
The ayurvedic treatment focuses on
(i) Managing the immune dysfunctions through anti-Ama measures
(ii) Supporting to neuro-muscular functions
(iii) Optimizing the overall health through Rasayana treatment.
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