Crisis miasténica, diagnóstico y tratamiento

Myasthenic crisis (MC) is a severe and potentially fatal complication of autoimmune myasthenia gravis (MG), characterized by an acute worsening of bulbar and respiratory muscle weakness that can lead to respiratory failure. It may occur in up to 20% of patients with MG, and in some cases constitutes the initial manifestation of the disease. Early recognition and early intervention are key to improving prognosis.

MC requires urgent, multidisciplinary management. Early respiratory support, immunotherapy with IVIG or PLEX, and appropriate use of immunosuppressants are critical for good outcomes. Current research on biologic therapies offers new alternatives for patients with refractory disease.

This article aims to comment on the current evidence and provide a comprehensive overview of the clinical features, diagnostic approach, triggering factors and therapeutic strategies in the management of MC, synthesizing pathophysiological mechanisms, ICU management protocols, immunotherapeutic interventions and new biologic therapies.