Myasthenia Gravis

Myasthenia gravis is an autoimmune disease caused by antibodies directed against the acetylcholine receptor at the neuromuscular junction, resulting in fatigable weakness of skeletal muscles. Effects on central cholinergic pathways and neuropsychologic function are controversial. This article will review the diagnosis of myasthenia gravis, using clinical, historical, pharmacologic, electrodiagnostic, and immunologic methods, and the treatment of myasthenia, both symptomatic and immunosuppressive. The effect of various medications on myasthenia gravis will also be reviewed to help prevent inadvertant acute exacerbation or unmasking of the disease.