[Myasthenia gravis. Information for the anesthetist and critical care physician]

Myasthenia gravis is an autoimmune-disorder and clinically characterised by weakness of voluntary muscles including respiratory and pharyngeal muscles. As myasthenia gravis is a rare disease surgeons and anesthesiologists are only seldomly confronted with patients suffering from this disease. However, the application of narcotics or of other drugs may lead to the manifestation of a subclinical form of myasthenia gravis or provoke a critical exacerbation of the patient's condition with severe respiratory and bulbar dysfunction. This paper describes guidelines for the use of narcotic drugs or other pharmacotherapy in myasthenia gravis patients. On the other hand this paper gives information about the intensive care and management of patients suffering from myasthenic of cholinergic crisis, which is known to be a lifethreatening emergency. Finally, the paper describes shortly the long-term treatment with immunosuppressive or immunoregulatory measures.