Journal
MUSCLE & NERVE
Volume 37, Issue 2, Pages 141-149Publisher
WILEY
DOI: 10.1002/mus.20950
Keywords
acetylcholine receptor antibodies; excitation-contraction coupling; generalized myasthenia gravis; muscle fatigue; muscle weakness; myasthenia gravis; ocular myasthenia gravis
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Between 1940 and 2000 a total of 1976 patients with myasthenia gravis (MG) were studied. Diagnosis was made by improvement in weakness after anticholinesterase medication. The historical developments in diagnosis and treatment of MG are reviewed. We analyzed the clinical course of MG as influenced by age, gender, thymectomy, thymomectomy, and the presence of antibodies to acetylcholine receptors (AChR). The clinical course of MG was significantly influenced by age and gender, and these need special attention in managing patients. The most severe level of weakness and high mortality occurred during the first 1 to 2 years of the disease, after which many patients experienced improvement. For treating MG patients the usefulness of thymectomy remains to be proven, and novel drugs need to be developed to increase the number as well as normal functioning of the AChRs and other components of the neuromuscular system.
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