Myasthenia Gravis: Treatment
Although there is no cure for MG, the disorder can be controlled. In fact, it is one of the more treatable neuromuscular disorders, responding well to a variety of therapies. However, the course of treatment for every patient is different. Your patient care team will tailor a program specifically to your needs that takes into account the severity of your weakness, the muscles affected, and your age, as well as any other associated medical problems.

Medications used to build muscle strength in MG patients include:

• Anticholinesterase agents, such as neostigmine and pyridostigmine, which prevent ACh destruction and increase the accumulation of ACh at neuromuscular junctions to improve neuromuscular transmission.
• Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine, which suppress the production of abnormal antibodies.

Patients taking these medications must be monitored carefully as they may cause major side effects.

A procedure called plasmapheresis, or plasma exchange, can also be used to treat more severe MG symptoms. Plasmapheresis is a process in which the fluid part of the blood, called plasma, is removed from blood cells by a device known as a cell separator. Several liters of blood are withdrawn intravenously and centrifuged. The patient’s red blood cells are then added either to plasma pooled from several healthy donors or to artificial plasma (plasma made of albumin and saline solution). This plasma/red blood cell mixture is then returned to the patient's blood stream. This process removes the abnormal anti-AChR antibodies from the patient’s body. A plasmapheresis treatment takes several hours and can be done on an outpatient basis. Plasmapheresis improves MG symptoms within days and improvement lasts 6–8 weeks.

A thymectomy, the surgical removal of the thymus gland, is another treatment option for MG patients. This procedure often decreases the severity of and in some cases eliminates MG symptoms. Symptomatic improvement generally occurs gradually following the surgery, with peak effects achieved within several months or years of surgery. Candidates for this procedure include patients with a tumor of the thymus and patients under the age of 55 with generalized MG.