Mindful Breathing Offers Relief for Myasthenia Gravis: A Case Report

Myasthenia Gravis (MG) is a disease characterized by proximal muscle weakness due to autoimmunity against acetylcholine receptors at the neuromuscular junction (NMJ). This case studies one MG patient who participated in thirty-minute breathing sessions twice per week during her three week hospitalization. The patient's disease-related ptosis noticeably improved after each session. Slow breathing stimulates the parasympathetic response via the vagus nerve, which operates via acetylcholine efferents. Vagal stimulation may therefore provide more neurotransmitter for the reduced number of ACh receptors in MG, resulting in more efficient binding at the NMJ and reduction in symptoms. Additionally, these results may be explained by the cholinergic anti-inflammatory pathway, wherein increased acetylcholine dampens the innate immune response. This report offers the possibility of a simple, non-pharmacological treatment of MG-related ptosis and potentially MG symptoms as a whole, with potential application toward other autoimmune disorders.