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Treatment of Acquired Autoimmune Myasthenia Gravis: a Topic Review

Published online by Cambridge University Press:  18 September 2015

Pradeep Verma  and
Joël Oger
Pradeep Verma
Affiliation:
Department of Medicine/Neurology, University Hospital and University of British Columbia, Vancouver
Joël Oger*
Affiliation:
Department of Medicine/Neurology, University Hospital and University of British Columbia, Vancouver
*
University Hospital UBC site, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 2B5
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Abstract:

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We propose a new approach to staging the disease based on clinical and immunological response to treatment. We oppose clinical remission to immunological remission and define total clinical remission as the goal of therapy. We describe the use, side effects and indications of established therapies. Acetycholine esterase inhibitors are only a symptomatic treatment as is plasma exchange. Usefulness and limits of thymectomy, corticosteroids and immunosuppressants are described here. Their goal is to reduce the auto-immune process. Long-term hazards from these medications are described and methods to reduce their potential risks are suggested. We suggest the number of patients having life threatening complications while undergoing aggressive immunosuppression can be reduced by a systematic approach to follow-up. In the second part of this review article, adapting management to specific situations is emphasized in refractory disease, respiratory failure, neonatal and juvenile forms of the disease. The special situation of seronegative myasthenia is discussed.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 19 , Issue 3 , August 1992 , pp. 360 - 375
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

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