Former tennis champion Monica Seles has recently spoken openly about living with the uncommon autoimmune condition myasthenia gravis, a disorder that affects roughly 12 out of every 100,000 people worldwide. According to Seles, her first signs of illness appeared suddenly about three years ago, catching her entirely off guard. She recalled experiencing episodes of double vision along with pronounced weakness in her arms and legs. These symptoms quickly made even routine tasks—like lifting a hairdryer—surprisingly difficult.
What exactly is this condition?
Myasthenia gravis is a long-term autoimmune disease in which the immune system interferes with normal communication between nerves and skeletal muscles. Under typical circumstances, nerve cells release a chemical messenger called acetylcholine. This molecule binds to receptors on muscle cells and signals them to contract. In individuals with myasthenia gravis, however, antibodies produced by the immune system target and block or destroy these receptors, preventing acetylcholine from working effectively.
The consequences are distinctive: muscle weakness that worsens with continued use but tends to improve after resting. This pattern is often referred to as “fatigability,” and it is one of the hallmark features of the disorder.
What symptoms can appear?
Because the disease affects voluntary muscles, it can disrupt many everyday functions such as walking, speaking, swallowing, or even breathing. Symptoms may emerge abruptly and often involve the eye muscles, leading to droopy eyelids or double vision. In more severe cases, muscle weakness can become so profound that breathing becomes compromised or food and liquids cannot be swallowed safely. This dangerous escalation, known as a “myasthenic crisis,” requires immediate hospital care and sometimes the use of life-support equipment.
During research interviews, a woman in her 30s living with the condition described how frightening a crisis can be. She explained that her speech becomes slow and slurred—almost as if she were intoxicated—while she simultaneously struggles for breath. At times, she cannot speak at all. She said having her mother present to advocate on her behalf has been vital, as she is often unable to explain what is happening. Remaining calm, she added, is one of the few things that helps her cope.
Another patient, a man in his 70s, recounted how abruptly the disease first appeared in his life. During his own 70th birthday celebration, he suddenly developed symptoms of ocular myasthenia gravis in the middle of a speech. His adult children, fearing he might be having a stroke, rushed him to a hospital—marking the unexpected beginning of his medical journey.
What causes it, and who is at risk?
The underlying cause of myasthenia gravis remains uncertain, though it is not believed to be hereditary. Some research suggests it might occur more frequently alongside other autoimmune conditions—including autoimmune thyroid issues, rheumatoid arthritis, and lupus—but the evidence is not fully established.
The disease can appear at any point in life. Early-onset cases occur more commonly in women under the age of 40, while men tend to develop the condition later in adulthood.
How is it diagnosed?
Despite its significant impact, myasthenia gravis often goes unrecognized for long periods because diagnosing it is complex. Diagnosis is primarily clinical, meaning an experienced physician must evaluate a patient’s symptoms, history, and presentation. Several tests—such as antibody blood tests, nerve conduction studies, and electromyography—may support the diagnosis, but none are definitively reliable on their own.
How is it treated?
Although there is currently no cure, several treatment options can help manage symptoms. These include anticholinesterase medications that improve muscle signaling, immunosuppressants that reduce immune activity, and procedures such as plasma exchange or intravenous immunoglobulin (IVIg), which remove or neutralize harmful antibodies. Some patients may also undergo surgical removal of the thymus gland, which is involved in the abnormal immune response. Access to these treatments can be uneven, particularly in regional areas.
Long-term outlook
While myasthenic crises can be life-threatening, current evidence suggests that most people with this condition do not experience a significant reduction in life expectancy. Some individuals require frequent hospital care; others have milder symptoms and need minimal treatment. Many describe the condition as unpredictable. As one woman who has lived with it for a decade noted, coping often means learning to adapt and finding a rhythm within the ongoing uncertainty.
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