Controversies about the treatment of myasthenia gravis

Clinicians treating patients with myasthenia gravis must choose cholinergic drugs, corticosteroids, immunosuppressive drugs, thymectomy, or plasmapheresis. Clinicians must decide the sequence or combination of these therapies and when to deem lack of improvement a sign for a different therapeutic approach. Because controlled trials have not been done to evaluate therapies that may require months or years before benefit is evident, controversy abounds.