Treatment of Myasthenia Gravis

Today, MG can be controlled. There are several therapies available to help reduce muscle weakness. Most persons with MG have good results from treatment. In some people MG, like many other autoimmune diseases, may go into remission (a period of time without symptoms) and muscle weakness may disappear completely.

Remission or improvement can occur without treatment in some cases. According to the Muscular Dystrophy Association, up to 20 percent of person with MG may have complete remission of symptoms without any treatment, and another 20 percent may improve without treatment. These spontaneous improvements are more likely to occur during early stages of MG.

Treatment of MG may include:

• Medications. Drugs used include cholinesterase inhibitors such as neostigmine and pyridostigmine. These drugs help improve nerve signals to muscles and increase muscle strength. Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine may also be used to suppress the production of abnormal antibodies. They must be used with careful medical followup because they can be associated with major side effects.

• Thymectomy, the surgical removal of the thymus gland (which is abnormal in most persons with MG). This surgery is done for persons with MG who have tumors, as well as for individuals without tumors. It improves symptoms in more than half of individuals without tumors. It may cure some people with MG, possibly by re-balancing the immune system.

Other therapies sometimes used to treat MG during especially difficult periods of weakness include:

• Plasmapheresis or plasma exchange. This is a procedure that removes abnormal antibodies from the blood.

• High-dose intravenous immune globulin. This treatment temporarily interferes with the ability of the immune system to damage the nerve muscle junction. Treatment options for a person with MG depend on the severity of the weakness, which muscles are affected, and the person's age and other medical problems.

In a few cases, MG may cause severe weakness resulting in acute respiratory failure. But most people can expect to lead normal or nearly normal lives.