Myasthenia Gravis

Myasthenia Gravis - Treatments

How is myasthenia gravis treated?

Intravenous Immune Globulin (IVIG) Treatment
IVIG is derived from donated blood and contains normal antibodies that temporarily counteract the abnormal antibodies in the body.
Plasma Exchange (Plasmapheresis)
Abnormal antibodies are filtered out of the body by a machine, similar to the concept of dialysis.

IVIG or plasmapheresis is used in acute cases.
Medications
Medication such as pyridostigmine is prescribed to improve muscle weakness. Common side effects include increased salivation, diarrhoea and abdominal discomfort.

Immunosuppressant such as steroid is prescribed to suppress the immune system. Side effects include weight gain, water retention, acne, hypertension, diabetes, infections, gastric ulcers, osteoporosis and cataracts. These side effects can be minimised with diet modications and medications.

The above list is not exhaustive and you should discuss these treatment options further with your doctor.
Surgery
In certain instances (e.g. thymoma), removal of the thymus gland is necessary.

With proper treatment, signs and symptoms of MG can be relieved and normal daily function achieved.

Neurology,

Myasthenia Gravis

Article contributed by Department of Neurosurgery, National Neuroscience Institute

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

Assoc Prof Chai Josiah

Senior Consultant

MBBS (Singapore), MRCP (United Kingdom), FRCP (Edinburgh), FAMS (Neurology)

Clinical Interests: Neuromuscular Disease, General Neurology

Dr Joy Vijayan

Consultant

FRCP (Edin), FAMS (Singapore)

Clinical Interests: Neuromuscular Disease, Clinical Neurophysiology

Dr Crystal Jing Jing Yeo

Consultant

MB BChir (Distinction, Cambridge), PhD (Cambridge), MRCP (UK), ABPN Board Cert (Neurology, Neuromuscular Medicine), ABEM Board Cert (Electrodiagnostic Medicine, Neuromuscular Ultrasound)

Clinical Interests: General Neurology, Neuromuscular Medicine, Electrodiagnostic Medicine, Neuromuscular Ultrasound

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Clinical Neurophysiology 2011; 122(1)\u0026#58; 188-93.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"26\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eDK Prashantha, AB Taly, S Sinha, TC Yasha, N Gayathri, JME Kovur, \u003cstrong\u003eJ Vijayan\u003c/strong\u003e. Familial amyloidotic polyneuropathy with muscle wasting, vitreous, leptomeningeal and cardiac involvement\u0026#58; Phenotypic, pathological and MRI description. Ann Indian Academy of Neurology 2010; 13(2) 142-144.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"27\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003e\u003cstrong\u003eVijayan J\u003c/strong\u003e, NG ST, Therimadasamy AK, Titus L, Wilder-Smith EP. A 54 year women with hand dysesthesia\u0026#58; many dimensions to a common problem. Neurology 2009; 73\u0026#58; e68-e72.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"28\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003e\u003cstrong\u003eVijayan J\u003c/strong\u003e, Therimadasamy AK, Teoh HL, Chan YC, Wilder-Smith EP. Sonography as an aid in diagnosing Tarsal tunnel syndrome. Am J Phy Med Rehab. 2009 Jun; 88(6)\u0026#58; 500-1.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"29\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003e\u003cstrong\u003eVijayan J\u003c/strong\u003e, Therimadasamy AK, Chan C, Wilder-Smith EP. Diagnostic utility of ultrasound in Posterior Interosseous Nerve Syndrome. Archives of Neurology 2009; 66(7)\u0026#58; 902-903.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"30\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eC Shyambabu, S Sinha, AB Taly, \u003cstrong\u003eJ Vijayan\u003c/strong\u003e, JME Kovoor. Serum B12 deficiency and hyperhomocysteinemia\u0026#58; A reversible cause of acute chorea, cerebellar ataxia in an adult with cerebral ischaemia. J Neurological Sciences 2008; 273\u0026#58; 152-154.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"31\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eMani RS, Yasha TC, Nagarathna S, Chandramukhi A, Shivprakash MR, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Prasantha DK, Pillai SV, Natarajan A, Kovoor J. Cerebral phaeohyphomycosis caused by Scytalidium dimidiatum\u0026#58; a case report from India. Medical Mycology 2008; 46\u0026#58; 705-711.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"32\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003e\u003cstrong\u003eJ Vijayan\u003c/strong\u003e, S Sinha, S Ravishankar, AB Taly. MR imaging in multiple system atrophy\u0026#58; Its role in \u0026quot;splitting\u0026#58; Parkinsonism. Ann Indian Academy of Neurology 2008; 11(4)\u0026#58; 257-258.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"33\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eKarkare K, Sinha S, Ravishankar S, Gayathri N, Yasha TC, Goyal MK, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Vannirajan A, Thangaraj K, Taly AB. Epilepsia partialis continua in mitochondrial dysfunction\u0026#58; Interesting phenotypic and MRI Observations. Ann Indian Academy of Neurology 2008; 11\u0026#58; 193-96\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"34\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003ePraveen Kumar S, Sinha S, Taly AB, Jayasree S, Ravi V, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Ravishankar. Electroencephalographic and imaging profile in a subacute sclerosing panencephalitis (SSPE) cohort\u0026#58; a correlative study. Clin Neurophysiol. 2007; 118(9)\u0026#58; 1947-54.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"35\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eKarkare K, Sinha S, Ravishankar S, Gayathri N, Yasha TC, Goyal MK, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Vannirajan A, Thangaraj K, Taly AB. Epilepsia partialis continua in mitochondrial dysfunction\u0026#58; Interesting phenotypic and MRI Observations. Ann Indian Academy of Neurology 2008; 11\u0026#58; 193-96.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"36\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003ePraveen KS, Sinha S, Chandrasekhar HS, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Taly AB. Sporadic onset Creutzfeldt-Jacob disease\u0026#58; Interesting MRI observations. Neurology India 2006; 54(4)\u0026#58; 418-420\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"37\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eKumar S, \u003cstrong\u003eVijayan J\u003c/strong\u003e, Jacob J, Aaron S, Joseph M, Alexander M, Gnanamuthu C. Cervical spine injuries in 64 attempted suicidal hangings in India. Tropical Doctor 2005; 35(4)\u0026#58; 198-200.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"38\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eS Aaron, S Kumar\u003cstrong\u003e, J Vijayan\u003c/strong\u003e, J Jacob, M Alexander, C Gnanamuthu. Clinical and laboratory features and response to treatment in patients presenting with Vitamin B12 deficiency related neurological syndromes. Neurology India 2005; 53\u0026#58; 55-58.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"39\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003e\u003cstrong\u003eVijayan J\u003c/strong\u003e, Alexander Mathew. Critical illness neuropathy. Indian J of Critical Care Medicine 2005; 9(1)\u0026#58; 32-34.\u003cbr\u003e\u003c/li\u003e\u003c/ol\u003e\u003col start=\"40\" style=\"list-style-type\u0026#58;decimal;\"\u003e\u003cli\u003eSrivatsa, Rajesh Jacob, Prathap Tharyan, \u003cstrong\u003eJoy Vijayan\u003c/strong\u003e, Mathew Alexander. Neuroacanthocytosis presenting with psychiatric symptoms. 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