Management of myasthenia gravis

Am J Ther. 2005 May-Jun;12(3):262-8.

Abstract

Myasthenia gravis (MS) is an immune-mediated disorder characterized by fluctuating weakness and fatigue of voluntary muscles. The muscular disorder is generalized in 85% and confined to extraocular muscles in 15% of patients. Pathophysiology of MG involves generation of antiacetylcholine receptor antibodies, which leads to a reduction of the number of acetylcholine receptors at the muscular motor endplate. This in turn results in fewer acetylcholine receptors available for stimulation, lower amplitude stimulations, less muscle fiber activation, and the eventual development of weakness in the affected muscles. The diagnostic workup for MS consists of administration of anticholinesterase agents (Tensilon test), repetitive nerve stimulation, Ach-R antibody assay, and single-fiber electromyography. Management of patients with MG includes cholinesterase inhibitors, corticosteroids, thymectomy, immunosuppressants, plasma exchange, and IVIg.

Publication types

  • Review

MeSH terms

  • Cholinesterase Inhibitors / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Myasthenia Gravis / drug therapy
  • Myasthenia Gravis / surgery
  • Myasthenia Gravis / therapy*
  • Plasma Exchange
  • Thymectomy

Substances

  • Cholinesterase Inhibitors
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents