Myasthenia gravis in clinical practice

ABSTRACT Background:  Myasthenia gravis is largely a treatable disease, but it can result in significant morbidity and even mortality, which can usually be avoided, or at least mitigated, with timely diagnosis and appropriate treatment of the disease. Objective: This review aims to summarize the mai...

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Published in:Arquivos de neuro-psiquiatria 2022-05, Vol.80 (S 05), p.257-265
Main Authors: Estephan, Eduardo de Paula, Baima, José Pedro Soares, Zambon, Antonio Alberto
Format: Article
Language:English
Subjects:
Acetylcholine receptors
Autoantibodies
Corticosteroids
Diagnosis
Electrophysiology
Humans
Immunosuppressive agents
Medical treatment
Morbidity
MUSCLE AND NEUROMUSCULAR JOINT DISORDERS
Muscle Weakness
Muscles
MUSK protein
Myasthenia
Myasthenia Gravis
Myasthenia Gravis - diagnosis
Myasthenia Gravis - therapy
Neuromuscular Diseases
Neuromuscular Junction
Neuromuscular Junction Diseases
Neuromuscular junctions
NEUROSCIENCES
Patients
Practice Guideline
PSYCHIATRY
Receptor Protein-Tyrosine Kinases
Receptors, Cholinergic
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Summary:ABSTRACT Background:  Myasthenia gravis is largely a treatable disease, but it can result in significant morbidity and even mortality, which can usually be avoided, or at least mitigated, with timely diagnosis and appropriate treatment of the disease. Objective: This review aims to summarize the main practical aspects of the diagnostic approach, treatment and care of myasthenic patients. Methods: The authors performed a non-systematic critical review summarizing the main practical aspects of myasthenia gravis. Results:  Most patients with myasthenia have autoantibodies targeted at acetylcholine receptors or, less commonly, muscle-specific kinase - MuSK. Electrophysiology plays an important role in the diagnosis of neuromuscular junction dysfunction. The central clinical manifestation of myasthenia gravis is fatigable muscle weakness, which can affect eye, bulbar, respiratory, and limb muscles. With rare exceptions, patients have a good response to symptomatic treatment, but corticosteroids and/or immunosuppressants are usually also necessary to obtain good control of the manifestations of the disease. Conclusion:  Knowledge of the peculiar aspects of their clinical and electrophysiological presentations is important for the diagnosis. Likewise, specific treatment and response time to each drug are crucial for proper care.
ISSN:0004-282X
1678-4227
1678-4227
DOI:10.1590/0004-282X-ANP-2022-S105