Myasthenia Gravis Care in Grand Rapids, Michigan

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder that causes muscle weakness and fatigue. In Grand Rapids, Michigan, people living with myasthenia gravis can access specialized care through major health systems such as Spectrum Health, Trinity Health Grand Rapids, Metro Health, and Mercy Health, as well as support from local public health resources.

Because MG symptoms can worsen with fatigue, infections, and extreme temperatures, understanding how this condition behaves in West Michigan’s cold winters and humid summers is especially important for residents of the Grand Rapids area.

What Is Myasthenia Gravis?

Myasthenia gravis is an autoimmune condition that affects the communication between nerves and muscles (the neuromuscular junction). The result is:

  • Weak muscles that get tired quickly
  • Weakness that improves with rest
  • Symptoms that can fluctuate from day to day or even hour to hour

In the early stages, MG often affects muscles that control:

  • Eye movements
  • Eyelid position
  • Facial expression
  • Chewing and swallowing

As the condition progresses, neck and limb muscles may also be involved, making it harder to:

  • Hold the head up
  • Climb stairs
  • Lift the arms
  • Walk long distances

If myasthenia gravis is not treated, the muscles used for breathing can be affected, which can become life-threatening. With appropriate care—often including medication, and sometimes surgery—most people in Grand Rapids with MG can manage their symptoms and maintain an active life.

Who Is Affected by Myasthenia Gravis?

Myasthenia gravis can affect people of any race, gender, or age—from childhood through older adulthood.

Patterns seen in MG include:

  • Women are affected nearly three times more often than men in early adulthood (under age 40).
  • After age 50, more men are affected than women.
  • MG is relatively uncommon in children under 15, except in some Asian countries where childhood-onset MG is more frequent.

Myasthenia gravis usually does not run directly in families. However, it is more common in people who have:

  • A personal history of another autoimmune condition (for example, type 1 diabetes, rheumatoid arthritis, or autoimmune thyroid disease)
  • A close relative with an autoimmune disease

A U.S. survey from 2009 estimated that about 1.2 out of every 10,000 people were being treated for MG. In a metro area the size of Grand Rapids, that means there are likely dozens to hundreds of residents living with this condition.

Symptoms of Myasthenia Gravis

Common symptoms of myasthenia gravis include muscle weakness that:

  • Worsens with activity or toward the end of the day
  • Improves after rest

Specific symptoms may include:

  • Eye symptoms

    • Double vision (diplopia)
    • Droopy eyelids (ptosis)
    • Difficulty maintaining a steady gaze

  • Facial and throat symptoms

    • Changes in facial expression
    • Difficulty chewing, especially tough foods
    • Trouble swallowing (dysphagia)
    • Slurred or nasal-sounding speech

  • Neck and limb weakness

    • Difficulty holding the head up
    • Trouble climbing stairs or standing from a seated position
    • Difficulty lifting arms above the head

  • Breathing symptoms

    • Shortness of breath
    • Feeling winded with mild exertion
    • In severe cases, difficulty breathing at rest

Because Michigan winters can be harsh, respiratory infections such as influenza, RSV, and pneumonia are common in the Grand Rapids area. These infections can significantly worsen MG symptoms, especially breathing problems, and may increase the risk of a myasthenic crisis. Vaccinations (such as flu and pneumonia shots) and early treatment of infections are especially important for people with MG in West Michigan.

What Causes Myasthenia Gravis?

Myasthenia gravis is one of many autoimmune diseases. Others include:

  • Rheumatoid arthritis
  • Type 1 diabetes
  • Autoimmune thyroid disease
  • Lupus

In a healthy immune system, antibodies help the body recognize and destroy foreign invaders such as bacteria and viruses. In autoimmune diseases, the immune system mistakenly produces antibodies that attack normal tissues.

In MG, the immune system targets the neuromuscular junction—the place where a nerve communicates with a muscle. Normally, nerves release a chemical messenger called acetylcholine (ACh), which binds to acetylcholine receptors (AChR) on the muscle, telling it to contract.

In myasthenia gravis:

  • About 85% of patients produce antibodies against the AChR.
  • These antibodies bind to and damage the receptors on the muscle surface.
  • With fewer working receptors, the muscle cannot respond as well to nerve signals, leading to weakness that worsens with repeated use.

Many people with MG who do not have AChR antibodies instead have antibodies to a protein called muscle-specific kinase (MuSK). This protein helps organize ACh receptors on the muscle cell surface.

Research continues to uncover other antibodies involved in MG. Recently, antibodies to a protein called LRP4 have been identified in some patients who do not have AChR or MuSK antibodies.

The exact trigger for autoimmune diseases like MG is not fully understood, but theories include:

  • Molecular mimicry – certain viruses or bacteria may have proteins that resemble human proteins such as AChR, confusing the immune system.
  • Thymus gland abnormalities – the thymus, a small gland in the chest involved in immune system development, appears to play a role in MG.
    • About 15% of people with MG have a thymic tumor (thymoma).
    • Around 65% have an overactive thymus (thymic hyperplasia).

When the thymus doesn’t function properly, the immune system may fail to distinguish self from non-self, increasing the risk of autoimmune attacks on the body’s own cells.

Myasthenic Crisis: A Medical Emergency

A myasthenic crisis occurs when the muscles involved in breathing become so weak that the person cannot breathe effectively on their own. This is a life-threatening emergency.

Symptoms of Myasthenic Crisis

  • Severe shortness of breath
  • Rapid or labored breathing
  • Difficulty speaking in full sentences
  • Inability to clear secretions or cough effectively
  • Feeling like you “can’t get enough air”

Triggers can include:

  • Respiratory infections (common during Grand Rapids’ winter and early spring)
  • Physical or emotional stress
  • Certain medications
  • Surgery or anesthesia
  • Pregnancy

Emergency Care in Grand Rapids

Anyone with MG who develops severe breathing problems should seek immediate care at an emergency department, such as:

  • Spectrum Health Butterworth Hospital
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health
  • Mercy Health facilities in the Grand Rapids area

Treatment may include:

  • Hospitalization, often in an intensive care unit
  • Breathing support with a ventilator if needed
  • Plasmapheresis or intravenous immunoglobulin (IVIG)
  • Adjustment of MG medications and treatment of any underlying infection

When myasthenia gravis is properly managed, myasthenic crisis is uncommon. Even when it occurs, modern respiratory care at Grand Rapids hospitals offers a good chance of recovery.

How Myasthenia Gravis Is Diagnosed in Grand Rapids

If your primary care provider or neurologist in Grand Rapids suspects MG based on your symptoms and physical exam, they may order several tests to confirm the diagnosis:

Blood Tests

Blood tests can detect antibodies commonly associated with MG, including:

  • Acetylcholine receptor (AChR) antibodies
  • MuSK antibodies
  • Sometimes LRP4 antibodies or other specialized tests

Most people with MG have antibodies to one of these proteins, which strongly supports the diagnosis.

Electromyography (EMG)

Electromyography evaluates how well nerves and muscles communicate. A specialized form called repetitive nerve stimulation can show whether muscle contractions become weaker with repeated stimulation—a hallmark of MG.

These tests are typically done by neurologists at hospitals and neuromuscular clinics in Grand Rapids, such as those affiliated with Spectrum Health or Metro Health.

Tensilon (Edrophonium) Test

Historically, the Tensilon test used a short-acting drug (edrophonium) that temporarily improved muscle strength in people with MG. This test is used less often today because of newer, safer diagnostic methods, but you may still see it mentioned in older materials.

Imaging of the Thymus Gland

Because thymus abnormalities are common in MG, imaging may be performed:

  • Chest X-ray
  • CT scan
  • MRI

These tests help detect thymomas or thymic hyperplasia and are available at major imaging centers across Grand Rapids.

Treatment Options for Myasthenia Gravis

There is currently no cure for myasthenia gravis, but symptoms can usually be managed effectively. Treatment plans in Grand Rapids are often coordinated by neurologists, sometimes in collaboration with rheumatologists, pulmonologists, and thoracic surgeons.

1. Lifestyle Changes

Daily habits can significantly affect MG symptoms, especially in a climate like West Michigan’s:

  • Get adequate rest and pace activities.
  • Avoid overexertion and schedule demanding tasks for times of day when you feel strongest.
  • Limit exposure to extreme heat or cold, which can worsen weakness.
  • Take extra precautions during cold and flu season in Grand Rapids (handwashing, masking when appropriate, vaccinations).
  • Work with your employer or school on accommodations if needed (flexible schedules, reduced physical demands).

2. Anticholinesterase Medications

The most commonly prescribed medication is pyridostigmine (Mestinon).

  • These drugs prevent the breakdown of acetylcholine, increasing its availability at the neuromuscular junction.
  • This improves the ability of muscles to contract.
  • Benefits usually begin within 30–60 minutes and last 3–4 hours, so doses are taken at regular intervals throughout the day.

Possible side effects:

  • Excessive salivation
  • Involuntary muscle twitching (fasciculations)
  • Abdominal cramping
  • Nausea
  • Diarrhea

Sometimes other medications are added to help reduce gastrointestinal side effects.

3. Corticosteroids

Medications such as prednisone are often used to suppress the immune system and reduce the production of harmful antibodies.

  • They may be used alone or with anticholinesterase medications.
  • Many people notice improvement within a few weeks.
  • Once symptoms stabilize, the dose is gradually reduced to the lowest effective level.
  • A low maintenance dose may be used long-term.

Long-term side effects can include:

  • Stomach ulcers
  • Osteoporosis (bone thinning)
  • Weight gain
  • High blood sugar or diabetes
  • Increased risk of infection

Because of these risks, Grand Rapids providers often combine steroids with other immunosuppressive drugs to allow lower steroid doses.

4. Other Immunosuppressive Drugs

Medications that may be used include:

  • Azathioprine
  • Mycophenolate mofetil (CellCept)
  • Cyclosporine
  • Cyclophosphamide (usually reserved for severe, treatment-resistant cases)

These drugs can be effective with fewer long-term side effects than high-dose corticosteroids, but they require careful monitoring with regular blood tests, which can be done through local labs in Grand Rapids.

5. Plasmapheresis

Plasmapheresis (plasma exchange) is a procedure in which:

  • Blood is removed from the body.
  • The plasma (which contains the harmful antibodies) is separated and discarded or treated.
  • The remaining blood components are combined with replacement fluid and returned to the body.

This treatment:

  • Provides rapid, temporary improvement in muscle strength.
  • Is often used to manage a myasthenic crisis or to stabilize patients before surgery.
  • May be used as long-term therapy in severe cases, though repeated treatments are usually needed because the immune system continues to produce antibodies.

Plasmapheresis is typically performed in hospital settings, such as Spectrum Health or Trinity Health Grand Rapids.

6. Intravenous Immunoglobulin (IVIG)

IVIG involves an infusion of pooled antibodies (immunoglobulin) from healthy donors. It:

  • Temporarily alters the immune response
  • Reduces the impact of harmful autoantibodies

IVIG is often used as short-term treatment during exacerbations or as an alternative to plasmapheresis. Infusions can be done in the hospital or in some outpatient infusion centers in the Grand Rapids area.

7. Thymectomy (Surgical Removal of the Thymus)

Surgical removal of the thymus gland (thymectomy) is recommended for some people with MG, especially those:

  • With a thymoma
  • With generalized MG and certain antibody profiles

Benefits of thymectomy:

  • Improvement is often gradual and may take months to years.
  • It is considered the only treatment that can sometimes lead to long-term, drug-free remission in selected patients.

Thymectomy is usually performed by thoracic surgeons at major hospitals in Grand Rapids with experience in minimally invasive and open chest surgery.

Living With Myasthenia Gravis in Grand Rapids

With proper treatment and support, many people with MG in Grand Rapids are able to work, attend school, and enjoy daily activities.

Practical Tips for West Michigan Residents

  • Plan for winter:

    • Avoid slippery conditions that increase fall risk if your leg muscles are weak.
    • Protect your lungs from cold air with a scarf or mask, especially if you have breathing issues.

  • Stay on top of vaccines:

    • Talk with your Grand Rapids provider about flu, COVID-19, and pneumonia vaccines.
    • These can help reduce infection risk, which is crucial for people with MG.

  • Coordinate care:

    • Keep an updated medication list and share it with all your providers.
    • Some drugs can worsen MG, so always check before starting new prescriptions.

  • Seek support:

    • Consider connecting with regional or national MG support organizations.
    • Ask your neurologist about local or virtual support groups serving West Michigan.

Where to Get Help in Grand Rapids, Michigan

If you think you may have symptoms of myasthenia gravis or have already been diagnosed and need ongoing care, you can start with:

  • Your primary care provider (GP/family doctor) – for initial evaluation and referrals.
  • Neurology clinics at:
    • Spectrum Health (Corewell Health) in Grand Rapids
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Mercy Health and affiliated neurology practices

Local public health and community resources include:

  • Kent County Health Department – information on vaccinations, infection prevention, and community health programs.
  • Grand Rapids Public Health resources – for education, chronic disease support, and referrals.

For rare neuromuscular diseases like MG, national organizations can also provide education and support. Your Grand Rapids neurologist can direct you to reputable groups and resources.

Key Points About Myasthenia Gravis

  • Myasthenia gravis is an autoimmune disease that causes muscle weakness and fatigue, often starting with eye and facial muscles.
  • Weakness typically worsens with activity and improves with rest.
  • Most patients have antibodies against AChR, MuSK, or other neuromuscular junction proteins such as LRP4.
  • There is no cure, but symptoms can usually be managed with medications, lifestyle changes, and sometimes surgery.
  • Corticosteroids often improve symptoms within weeks, and the dose is gradually reduced once stability is achieved.
  • Myasthenic crisis, marked by severe breathing problems and shortness of breath, is a medical emergency requiring hospital care.
  • Residents of Grand Rapids, MI, have access to multiple hospital systems and specialists experienced in diagnosing and treating myasthenia gravis.