Myasthenia gravis

Treatment:

There is no known cure for myasthenia gravis. However, treatment may result in prolonged periods of remission, without symptoms.

Medications, including anticholinesterase medications such as Neostigmine or Pyridostigmine, should be given 30 minutes before meals to maximize the ability to eat and swallow. Prednisone or other medications that suppress the immune response may be used if symptoms are severe and there is inadequate response to other medications. Some medications (such as the aminoglycosides) may make symptoms worse and should be avoided.

Lifestyle adjustments may enable continuation of many activities. Activity should be planned to allow scheduled rest periods. An eye patch may be recommended if double vision is bothersome. Stress should be avoided, because it worsens symptoms.

Plasmapheresis, a technique in which blood plasma containing antibodies against the body is removed from the body and replaced with fluids (donated antibody-free plasma or other intravenous fluids), may reduce symptoms in some cases.

Surgical removal of the thymus (thymectomy) results in permanent remission for many people.

Crisis situations, where muscle weakness involves the breathing muscles, may occur. These attacks seldom last longer than a few weeks. Hospitalization and assistance with breathing may be required during these attacks.

The stress of illness can often be helped by joining support groups where members share common experiences and problems. See myasthenia gravis - support group.

Expectations (prognosis):

There is no cure, but long-term remission is possible. There may be minimal restriction on activity in many cases. Pregnancy is possible but should be closely supervised; the baby may require medications for a few weeks after birth but usually does not develop the disorder.

Complications:

• restrictions on lifestyle (possible)
• side effects of medications (See the specific medication.)
• complications of surgery
• myasthenic crisis (breathing difficulty), may be life threatening

Calling your health care provider:

Call your health care provider if the symptoms indicate myasthenia gravis may be present.

Go to the emergency room or call the local emergency number (such as 911) if myasthenia gravis has been diagnosed and breathing difficulty occurs (emergency situation).