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Update on myasthenia gravis

¹ Department of Integrated Medicine, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
² Department of Integrated Medicine, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK

Correspondence to:
Correspondence to:
Dr Bhom Raj Thanvi
Department of Integrated Medicine, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Infirmary Square, Leicester LE1 5WW, UK; bthanvi{at}hotmail.com

Myasthenia gravis is an autoimmune disorder caused by autoantibodies against the nicotinic acetylcholine receptor on the postsynaptic membrane at the neuromuscular junction and characterised by weakness and fatigability of the voluntary muscles. It has a bimodal peak of incidence with first peak in the third decade and the second peak in the sixth decade. It is probably underdiagnosed in the very old population. Our understanding of the pathogenesis, immunology, and molecular biology of myasthenia gravis has greatly improved in last three decades. It is almost always possible to establish the diagnosis of myasthenia gravis with the current tests. The modern treatment is highly successful and the mortality of treated myasthenia gravis is practically zero. However, there are still important gaps in our knowledge of the origin of myasthenia gravis, the factors that contribute to chronic disease, and the way to cure the disease. In this article the current knowledge of the various aspects of myasthenia gravis are outlined.

Abbreviations: AChR, acetylcholine receptor; EPP, endplate potential; MRI, magnetic resonance imaging; MuSK, muscle specific protein kinase

Keywords: myasthenia gravis; autoimmune disorder