Myasthenia Gravis

Myasthenia gravis (MG) is the prototypical autoimmune antibody-mediated disease characterized by muscle weakness and fatigability. The antibodies cause reduced numbers of available acetylcholine receptors at neuromuscular junctions. In addition to destruction of acetylcholine receptors, they can change the surface membrane clustering of receptors or cause change in the postsynaptic membrane architecture. The final result is impaired neuromuscular transmission. Generalized myasthenia can affect the limbs, bulbar, facial, and respiratory muscles. The diagnosis of MG can be made in clinic with clinical tests such as the sleep test and ice test. Serological testing for acetylcholine receptor antibodies and for the antibodies to muscle-specific tyrosine kinase and low-density lipoprotein receptor-related protein 4 will be discussed. Ocular myasthenia gravis is a subtype of myasthenia with weakness that is clinically isolated to the extraocular, levator palpebrae superioris, and orbicularis oculi muscles. MG is a treatable disease. Thymectomy is indicated for certain subgroups of MG. The treatment of MG has expanded with the usage of newer immune modulating drugs.