Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
Fundação Faculdade Regional de Medicina de São José do Rio Preto, Hospital de Base, Departamento de Neurologia, São José do Rio Preto SP, Brazil.
Arq Neuropsiquiatr. 2022 May;80(5 Suppl 1):257-265. doi: 10.1590/0004-282X-ANP-2022-S105.
Myasthenia gravis is largely a treatable disease, but it can result in significant morbidity and even mortality, which can usually be avoided, or at least mitigated, with timely diagnosis and appropriate treatment of the disease. Objective: this review aims to summarize the main practical aspects of the diagnostic approach, treatment and care of myasthenic patients.
The authors performed a non-systematic critical review summarizing the main practical aspects of myasthenia gravis.
Most patients with myasthenia have autoantibodies targeted at acetylcholine receptors or, less commonly, muscle-specific kinase - MuSK. Electrophysiology plays an important role in the diagnosis of neuromuscular junction dysfunction. The central clinical manifestation of myasthenia gravis is fatigable muscle weakness, which can affect eye, bulbar, respiratory, and limb muscles. With rare exceptions, patients have a good response to symptomatic treatment, but corticosteroids and/or immunosuppressants are usually also necessary to obtain good control of the manifestations of the disease.
Knowledge of the peculiar aspects of their clinical and electrophysiological presentations is important for the diagnosis. Likewise, specific treatment and response time to each drug are crucial for proper care.
重症肌无力在很大程度上是一种可治疗的疾病，但它可能导致严重的发病率，甚至死亡率，通常可以通过及时诊断和适当的疾病治疗来避免，或至少减轻。目的：本综述旨在总结重症肌无力患者的诊断方法、治疗和护理的主要实用方面。
作者进行了非系统性的批判性综述，总结了重症肌无力的主要实用方面。
大多数重症肌无力患者的自身抗体针对乙酰胆碱受体，或不太常见的是肌肉特异性激酶-MuSK。电生理学在神经肌肉接头功能障碍的诊断中起着重要作用。重症肌无力的中央临床表现是易疲劳的肌肉无力，可影响眼、球、呼吸和肢体肌肉。除了罕见的例外情况，患者对症状治疗有很好的反应，但通常还需要皮质类固醇和/或免疫抑制剂来获得对疾病表现的良好控制。
了解其临床和电生理表现的特殊方面对于诊断很重要。同样，每种药物的特定治疗和反应时间对于适当的护理也是至关重要的。
