Treatment of Myasthenia Gravis

Treatment of Myasthenia Gravis

Advances in treatment have lead to better prognosis. Proper treatment allows most patients to enjoy better lives. Available treatment modalities include: anticholinesterase medications, immunosuppressive agents, thymectomy, and plasmapheresis and intravenous immunoglobulin (IVIg). Many patients benefit from Predisone.

• Anticholinesterase medications: Pyridostigmine is the most widely used drug belonging to this class. Partial improvement occurs in many patients. Complete cure may not be possible.
• Immunosuppressive agents: Majority of patients benefit from the use of drugs that suppress the immune system. Drugs include glucocorticoids, Mycophenolate mofetil, azathioprine, cyclosporine, tacrolimus, and cyclophosphamide.
• Thymectomy: This is the surgical removal of thymus gland (already mentioned). Some patients benefit from it.
• Plasmapheresis (Plasma exchange) can bring short term improvement. Abnormal antibodies are removed from plasma of the blood. Improvement brought about, though striking is transient. Repeated exchanges may be required.
• Intravenous immunoglobulin (IVIg): Infusion with immunoglobulin is also used to bring transient improvement.

Myasthenia crisis is said to occur when the patient develops breathing problems. Weakness of respiratory muscles warrants immediate medical attention.

References:

1. Cecil Medicine, 23rd Ed.
2. Harrison's Principles Of Internal Medicine, 17^th Edition.

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