What is Myasthenia Gravis, the rare autoimmune disease Arun Bali was suffering from?

Veteran actor Arun Bali passed away on Friday morning around 4:20 AM at the age of 79. Best known for his memorable performances in the TV show Swabhimaan and the popular film 3 Idiots, he was suffering from Myasthenia Gravis, an autoimmune disease caused by a communication failure between nerves and muscles, according to his son Ankush. “He was suffering from Myasthenia Gravis. He had mood swings for two-three days. He told the caretaker he wanted to go to the washroom and after coming out he said that wanted to sit down; he never got up then,” he told PTI.

What is Myasthenia Gravis?

According to Dr Krishnan PR, Consultant Neurology, Fortis Hospital, Bannerghatta Road, Bangalore, “It is a rare neuromuscular disease of autoimmune origin in which weakness of the skeletal muscles – muscles used for body movement – ​​happens. This happens when the communication between the muscles and the nerve cells become impaired due to certain deficiencies in chemicals.”

Agreeing, Dr Kadam Nagpal, Senior Consultant, Neurology, PSRI Hospital, added that Myasthenia Gravis can occur anytime — from infantry to late adulthood. “When it happens during infantry, it is called congenital Myasthenia Gravis, and when it is developed later, it is called acquired Myasthenia Gravis,” he said.

Causes

Experts explained that this condition is caused by a defect in the action of acetylcholine – a neurotransmitter – at the neuromuscular junction. “Between a nerve and a muscle, there is a junction called a neuromuscular junction where the chemical acetylcholine acts as a facilitator molecule in order to increase locomotion and muscle strength. It carries electrical impulses from the nerve and imparts it to the muscle,” Dr Nagpal said.

In Myasthenia Gravis, antibodies against acetylcholine receptors are developed. “When acetylcholine attaches to the receptor and the facilitation of the impulses takes place, autoantibodies attack those receptors and result in neuromuscular weakness,” he added.

Symptoms

Below are some common symptoms of Myasthenia Gravis, according to neurologists.

Actor Arun Bali was admitted to the hospital early this year (Express Archive)

*Double vision
*Drooping eyelids
*Difficulty in speaking, chewing or swallowing
*Difficulty in flexing or extending their head up
*Difficulty in walking
*Breathing difficulties

“Classic elements include fatiguability and fluctuation. Patients become increasingly fatigued during the course of the day and the weakness also fluctuates during the day,” Dr Nagpal said.

Who is at an increased risk?

According to Dr Krishnan, while nobody is more at risk, per se, but certain genetic markers can identify those at an increased risk. “However, these are not commonly used,” he said.

People who have a family history are at risk, Dr Nagpal elucidated. “Though there’s no direct transmission from one member to another, they are definitely more predisposed as compared to the general population. It can also be seen in patients who might have some form of distant cancer inside the body as a paraneoplastic process. The most common process that we see is thymic hyperplasia or thymoma in about 10 per cent of the cases. In this condition, either the thymus gland is enlarged or there is some kind of cancer formation in that gland.”

Prevention

Dr Krishnan highlighted that prevention of Myasthenia Gravis is not possible since the reason behind it is not fully known. “But, in case someone is suffering from it, they can take certain steps to avoid exacerbation,” he added, listing the following preventive measures after the diagnosis.

*Treat infections promptly
*Don’t overexert
*Learn to manage stress better
*Sleep adequately
*Have a balanced diet

“Patients may have a stormy course initially, but in this ailment, they can achieve remission with long-term treatment,” Dr Nagpal concluded.

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