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Myasthenia Gravis

  • Neuroimmunology
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Opinion statement

Treatment of patients with acquired (autoimmune) myasthenia gravis should rely on evidence-based therapeutic choices, taking into account the individual’s needs according to disease severity (mild to severe), extent (ocular or generalized), comorbidities (including other autoimmune diseases, infections, thymoma, and pregnancy), age, iatrogenic factors (the risks and benefits of therapy), patient autonomy and quality of life, financial burden to the patient, and associated health care costs. Therapy is aimed at managing symptoms by improving neuromuscular junction transmission (cholinesterase inhibitors) and/or modifying the underlying immunopathogenetic cause of acquired myasthenia gravis via immunosuppression or immunomodulation. Myasthenic patients with operable thymoma should be referred for surgery and closely followed up for tumor recurrence. A concerted international effort is addressing treatment recommendations for thymectomy in myasthenic patients with no radiologic evidence of thymoma who are positive for circulating acetylcholine receptor antibodies. There is a lack of evidence-based treatment guidelines for both acute and long-term management of ocular myasthenia. Acute management of myasthenic crisis requires intensive monitoring of the patient and institution of an efficient and safe treatment such as plasma exchange. Patient education is essential to a comprehensive long-term treatment plan.

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No potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. Department of Neurology, Neuromuscular Division, Wayne State University, School of Medicine, 8A University Health Center, 4201 St. Antoine, Detroit, MI, 48201, USA

    Agnes Jani-Acsadi MD

  2. Department of Neurology, Wayne State University, School of Medicine, 8A University Health Center, 4201 St. Antoine, Detroit, MI, 48201, USA

    Robert P. Lisak MD

Authors
  1. Agnes Jani-Acsadi MD
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  2. Robert P. Lisak MD
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Correspondence to Agnes Jani-Acsadi MD.

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Jani-Acsadi, A., Lisak, R.P. Myasthenia Gravis. Curr Treat Options Neurol 12, 231–243 (2010). https://doi.org/10.1007/s11940-010-0070-0

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  • DOI: https://doi.org/10.1007/s11940-010-0070-0

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