Diagnosis and Management of Myasthenia Gravis

This case-based book answers the questions people with myasthenia gravis ask most urgently, from the fear of progression in ocular disease to the possibility of life-threatening myasthenic crisis and the realities of lifelong management. Through real-world clinical scenarios, it traces the evolution of our understanding of myasthenia gravis, highlighting key historical milestones, shifting epidemiology, and the wide spectrum of typical and atypical presentations that define this complex disorder. This book comprehensively covers topics related to clinical aspects of diagnosing and treating myasthenia gravis. Each chapter unfolds as a clinical encounter, guiding readers through diagnostic reasoning at the bedside and in the laboratory, including antibody testing, electrodiagnostics, and common diagnostic pitfalls, and usage of proper treatment. The cases illuminate frequent mistakes that delay diagnosis or lead to ineffective treatment, while offering practical strategies to avoid them. Special attention is given to ocular myasthenia, generalized myasthenia with typical and atypical presentations, myasthenic crisis, seronegative disease, thymoma-associated myasthenia gravis, pregnancy planning, allowance and avoidance of medications that could trigger myasthenic exacerbation, and challenging overlaps with conditions such as diabetes, thyroid disease, and infection. Discussions on differentiation from disorders with similar presentations such as congenital myasthenic syndromes, Lambert-Eaton myasthenic syndrome and botulism are provided. From first symptoms to refractory disease and crisis management, this book provides a clear, concise experience-driven approach to treatment selection and adjustment. Traditional therapies and modern targeted agents are discussed alongside real patient outcomes, including the proper use of pyridostigmine, corticosteroids, non-steroidal immunosuppressive therapy, intravenous immunoglobulin, plasmapheresis, complement inhibitors, FcRn antagonists, B cell depletion therapy, and thymectomy. Designed for neuromuscular specialists, neurologists, trainees, and informed clinicians, this book serves as both a trusted guide and a clinical companion for navigating the full course of myasthenia gravis with confidence and clarity.