Myasthenia Gravis is a Neuromuscular disorder that can cause severe weakness in various parts of the body. It can be a more localized disease or more generalized.

It is not very common and I saw a case recently where the muscular dysfunction was mostly in the head and neck area and involved speech. The underlying “cause” of MG is dysfunction of acetylcholine, a critical neuromuscular junction activator. In other words, Acetylcholine bridges the signal from a nerve to a muscle cell to contract. Antibodies are formed that effect the receptor thereby requiring more acetylcholine.

MG is treated with medicines that increase acetylcholine or block antibody formation. In the end, the MG patients are just missing adequate ACh around the muscle cell.

I started the patient on low dose CBD with some modest success, but when a very modest dose of THC-A was added to the regimen, the patient rapidly improved – I barely recognized her speech on the phone. Her speech improved after the first dose and she has continued to improve to where her speech and strength are nearly back to normal.

This is just the initial response and more time in follow up is needed, but the response was definite and substantial.

In looking through PubMed or the National Library of Medicine, there was an article that caught my attention. In this article, it makes a very good case that the cannabinoids interfere with the enzyme “acetylcholine esterase”, the enzyme mentioned above. By interfering with this enzyme that breaks down ACh, more acetylcholine is available at the neuromuscular junction.

It is also possible that the circulating antibody is affected.

Regardless, it is real and we need a lot more patients with MG.

Do you know anyone??

Allan Frankel, MD

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