Name of the Condition

• Myasthenia Gravis without (acute) exacerbation
• Technical term: Myasthenia Gravis (MG), ICD Code G70.00

Summary

Myasthenia Gravis is a chronic autoimmune neuromuscular disorder that causes weakness in the skeletal muscles. Without acute exacerbation, the condition is stable and not experiencing a sudden worsening of symptoms.

Causes

Myasthenia Gravis is primarily caused by an autoimmune response in which antibodies attack the communication between nerves and muscles, particularly at the neuromuscular junction, leading to muscle weakness.

Risk Factors

• Age: Can occur at any age, but common in women under 40 and men over 60.
• Family history of autoimmune diseases.
• Co-existing autoimmune disorders.

Symptoms

• Muscle weakness that worsens with activity and improves with rest.
• Drooping of one or both eyelids (ptosis).
• Blurred or double vision (diplopia).

• Difficulty in swallowing and speaking.

  Diagnosis

• Blood tests for specific antibodies (e.g., anti-acetylcholine receptor antibodies).
• Electromyography (EMG) to assess muscle response.
• Imaging tests if thymoma is suspected.
• Edrophonium test for temporary symptom relief that helps confirm diagnosis.

Treatment Options

• Medications like acetylcholinesterase inhibitors (e.g., pyridostigmine) to improve muscle contraction.
• Immunosuppressive drugs to reduce antibody production.
• Thymectomy if thymoma is present or contributing to MG.
• Plasmapheresis or intravenous immunoglobulin (IVIG) in severe cases.

Prognosis and Follow-Up

• Patients can have a normal life expectancy with proper management.
• Regular follow-up is essential to monitor symptoms and adjust treatment.
• Some may achieve remission or stable symptoms without frequent exacerbations.

Complications

• Respiratory crisis if breathing muscles are severely affected.
• Higher risk of other autoimmune disorders.
• Muscle atrophy over time without proper management.

Lifestyle & Prevention

• Maintain a balanced diet and healthy weight.
• Regular, gentle exercise to improve muscle strength.
• Avoid stress and overexertion, which can worsen symptoms.
• Preventive measures include regular monitoring and adherence to treatment.

When to Seek Professional Help

• Sudden increase in muscle weakness, especially in muscles controlling breathing or swallowing.
• Signs of a myasthenic crisis, like difficulty breathing or severe difficulty swallowing.

Additional Resources

• Myasthenia Gravis Foundation of America (MGFA)
• National Institute of Neurological Disorders and Stroke (NINDS)
• Autoimmune Association

Tips for Medical Coders

• Ensure the documentation specifies "without acute exacerbation" for accurate coding.
• Avoid confusing with other types of myasthenia or conditions involving acute crises (G70.01 for exacerbation).
• Verify if associated treatments (e.g., thymectomy) impact coding.