Current Treatment Options in Neurology

, Volume 12, Issue 3, pp 231–243

Myasthenia Gravis

Authors

    • Department of Neurology, Neuromuscular DivisionWayne State University, School of Medicine
  • Robert P. Lisak
    • Department of NeurologyWayne State University, School of Medicine
Neuroimmunology

DOI: 10.1007/s11940-010-0070-0

Cite this article as:
Jani-Acsadi, A. & Lisak, R.P. Curr Treat Options Neurol (2010) 12: 231. doi:10.1007/s11940-010-0070-0

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.

Copyright information

© Springer Science+Business Media, LLC 2010