Myasthenia Gravis

Myasthenia gravis is an autoimmune disease characterized by weakness and rapid fatigue of the voluntary muscle system. Like multiple sclerosis, this is a breakdown between the normal communication between the nervous system and the muscles.

Signs and symptoms include weakness of the voluntary muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing. Though this disease can affect people of any age, it's more common in women younger than 40 and in men older than 60.

Causes

While no one can say what triggers myasthenia gravis, some of the mechanisms are understood. Antibodies in MG patients are produced that block and/or destroy receptor sites for neurotransmitters. Fewer receptor sites result in less ability for the central nervous system to communicate with the muscles. Tumors of the thymus gland are also thought to contribute to MG. Fatigue, stress, medications (beta blockers, some of the quinidines and quinine, some anesthetics and antibiotics), pregnancy, and menstrual periods can worsen MG.

From a Chinese medicine perspective, myasthenia gravis is complex with many organs and systems involved. There is no set progression of the disease. Instead, this depends on pathogenic factors involved and mechanisms affected.

• Exogenous pathogens. Various exogenous pathogens lead to impaired organ and channel function and in turn lead to deficiency of Qi and Blood causing the muscle, tendon, and flaccidity symptoms.

• Endogenous causes. We're mostly talking about emotions here. Anger damages the Liver, fear impairs the Kidneys, overthinking and rumination impairs the Spleen. Liver impairment can cause blood not to flow correctly to the tendons, Kidney impairment affect the marrow and bones, and Spleen can then no longer fully support the muscles and energy levels. Spleen Qi deficiency also results in poor blood quality and volume, exacerbating the numbness and weakness of the musculature.

• Lifestyle contributing factors. Improper diet such as eating too much greasy or sweet food, excessive alcohol consumption will stress and injure the middle jiao, the earth element. The Spleen and Stomach are vital for extracting the nutritive esence from food and drink. Without this Qi, the muscles can become weak, can cause the drooping eyelids often associated with myasthenia gravis, and make breathing difficult.

• Congenital factors. Those born with a weak middle jiao, yang xu of the Spleen or kidneys or yin xu of the liver and kidneys are more susceptible to disease.
  

Acupuncture protocol for multiple sclerosis

This is a basic protocol. You can add points intelligently thinking in terms of channel association and point function to customize this prescription.

Bilateral or midline:

• Yintang, Du 20

Right side:

• Shang Liu (Upper Tumor)

• Ki 1, Ki 3, Ki 5

• Huo Ying, Huo Zhu, Lv 6* *Master Tung's Lv 6 is needled next to the tibia on the Spleen channel rather than on the bone itself. Use your fingernail to palpate and slide the needle right next to the bone.

Left side:

• Xia San Huang

• St 36, St 37

• Wai San Guan

Point discussion

• Yintang and Du 20 This directs energy up to the brain, sending more Blood and Qi to the central nervous system. You could think of these as guiding points for the overall energy generated by the point prescription.

• Shang Liu is awesome for headaches, migraines, and empty dull head pain. Clears the mind and has a direct effect for the top of the head and brain. If you think of the leg as a microsystem for the body, the location of this point mirrors the head and the brain. The fact that it is on the calcaneal bone strengthens the association with the Kidney channel, marrow and the brain.

• Kidney 1, 3, and 5 target the brain and nervous system for similar reasons listed in Shang Liu above, affecting the Kidney channel, marrow, and the brain.

• Huo Ying, Huo Zhu, and Liver 6 are all Liver channel points which help to move blood. They also help calm the Liver channel and control Liver Yang to help with tremors.

• Xia San Huang is a three point combination on the Spleen meridian. This combination contains the Shen Guan point which is Kidney tonifying and regulating and also has similar functions to Spleen 9 to help with damp. Stomach 36 is the He Sea and Lower He Sea of the Stomach channel. This combination of Spleen and Stomach channel points tonifies the Earth element to help generate more Qi and more Blood. St 37 is the Lower He Sea of the Large Intestine meridian and helps eliminate toxins from the body. The Earth element is always central to disease!

• Wai San Guan, the Other Three Passes, are on the Gallbladder channel and help control movement and pain.

Basic herbal prescriptions include Tian Ma Gou Teng Yin to help with paralysis and tremors, Ba Zhen Tang to tonify Blood, and Bu Zhong Yi Qi Tang to tonify the middle jiao. You might also consider Liu Jun Zi Tang if there is significant damp and phlegm. Consider Qi Ju Di Huang Tang as a way to treat the eye problems and drooping eyelids.