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Myasthenia Gravis: Overview and Treatment

Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...

Myasthenia Gravis: Diagnostic Tests

Myasthenia Gravis: Diagnostic Tests

Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...

Disorders of the Skeletal Muscle

Disorders of the Skeletal Muscle

The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...

Chemical Synapses

Chemical Synapses

Chemical synapses are specialized sites between two neurons or between a neuron and a non-neuronal cell like a muscle, glandular or sensory cell.
Because chemical synapses depend on the release of neurotransmitter molecules from synaptic vesicles to pass on their signal, there is an approximately one millisecond delay between when the axon potential reaches the presynaptic terminal and when the neurotransmitter leads to opening of postsynaptic ion channels. Additionally, this signaling is...

Skeletal Muscle Relaxants: Adverse Effects

Skeletal Muscle Relaxants: Adverse Effects

Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...

Muscle Contraction

Muscle Contraction

In skeletal muscles, acetylcholine is released by nerve terminals at the motor endplate—the point of synaptic communication between motor neurons and muscle fibers. The binding of acetylcholine to its receptors on the sarcolemma allows entry of sodium ions into the cell and triggers an action potential in the muscle cell. Thus, electrical signals from the brain are transmitted to the muscle. Subsequently, the enzyme acetylcholinesterase breaks down acetylcholine to prevent excessive...

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Related Experiment Video

Updated: Aug 1, 2025

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Published on: April 12, 2011

Myasthenic crisis.

Benjamin Claytor¹, Sung-Min Cho², Yuebing Li¹

¹Neuromuscular Center, Department of Neurology, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

|April 28, 2023

Summary

This summary is machine-generated.

Myasthenic crisis (MC), a severe form of myasthenia gravis (MG), involves respiratory failure. Prompt treatment and trigger identification improve outcomes, with most patients recovering well.

Keywords:

mechanical ventilation myasthenia gravis myasthenic crisis plasmapheresis

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Area of Science:

Neurology
Critical Care Medicine

Background:

Myasthenic crisis (MC) is a severe, life-threatening complication of myasthenia gravis (MG) characterized by respiratory insufficiency.
MC necessitates ventilatory support and affects 15-20% of MG patients, often early in the disease course.

Purpose of the Study:

To review the definition, epidemiology, risk factors, triggers, management, and outcomes of myasthenic crisis.

Main Methods:

Literature review and synthesis of existing data on myasthenic crisis.

Main Results:

Respiratory infections are common triggers, but 30-40% of MC cases lack a specific trigger.
Risk factors for MC include prior crisis, severe MG, bulbar weakness, MuSK antibodies, and thymoma.
Plasmapheresis is the preferred treatment over IVIg; most patients wean from ventilation within a month.

Conclusions:

Myasthenic crisis outcomes are generally favorable with prompt management, and mortality is low (<5% in US cohorts).
MC does not typically impact long-term myasthenia gravis prognosis, allowing for good disease control post-crisis.