Medical and surgical management of Myasthenia Gravis

Myasthenia gravis (MG) is an autoimmune disease affecting the neuromuscular junction, responsible for the production of autoantibodies against acetylcholine receptors in striated skeletal muscle. This is responsible for the appearance of fluctuating muscular fatigue which, when generalized, can be life-threatening. The association of myasthenia seen in thymic pathology was first described in 1901 by Laquer, and medical treatment (essentially including drugs to increase neuromuscular transmission, immunosuppressants, immunoglobulins, monoclonal antibodies or plasma exchange) is often combined with surgical management to achieve simple or enlarged thymectomy.The earlier a patient undergoes thymectomy, the better the outcome in terms of post-thymectomy morbidity and mortality. This book outlines the medical and surgical management of MG.