How to treat myasthenia gravis?

Written by Zhang Hui
Neurology
Updated on May 25, 2025
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Myasthenia gravis falls under the category of neurological diseases, characterized as an immune disorder of the nervous system, primarily due to the presence of antibodies against acetylcholine receptors. This leads to impaired transmission of nerve impulses to muscles, resulting in various clinical symptoms. The treatment approaches for myasthenia gravis include the following. Firstly, the use of cholinesterase inhibitors is recommended. These medications increase acetylcholine levels and are effective in improving symptoms. Secondly, patients are treated with corticosteroids, typically starting with a low dose and gradually increasing to maintain for a period before reducing the dose again. Adjustments to medication should always be made under the guidance of a neurologist. Third, if the patient has a thymoma, surgical removal is advised.

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Written by Liu Hong Mei
Neurology
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Can metronidazole be used for myasthenia gravis?

Patients with myasthenia gravis must use ornidazole with caution and under the guidance of a doctor because the side effects of ornidazole may exacerbate myasthenia gravis. However, ornidazole is not relatively or absolutely contraindicated for patients with myasthenia gravis. Generally, the patient's side effects are observed, and if myasthenia gravis is aggravated, the use of ornidazole is recommended to be cautious or prohibited. Ornidazole can cause neurological reactions, including headache, fatigue, dizziness, trembling, limb numbness and weakness, convulsions, mental confusion, epileptic seizures, ataxia, and consciousness disturbances, and may cause peripheral nerve damage.

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Written by Zhang Hui
Neurology
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Myasthenia Gravis Clinical Manifestations

Myasthenia gravis is a type of immunological disease of the nervous system that belongs to neurology. The common clinical manifestations include the following aspects. First, some patients may experience ptosis, where they cannot open their eyes. It usually starts on one side and may also involve abnormal eye movements, such as difficulty in moving the eyes to the left or right, leading to double vision and other clinical manifestations. Second, some patients may experience dysphagia, such as difficulty swallowing, choking on water, and speech articulation disorders. Third, some patients may experience weakness in their limbs, especially an inability to perform strenuous physical activities, such as climbing stairs, which can be significantly affected. These clinical manifestations usually show a pattern of being less severe in the morning and more severe in the evening.

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Written by Zhang Hui
Neurology
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What is myasthenia gravis?

Myasthenia gravis is a group of neuromuscular junction disorders and is also an autoimmune disease of the nervous system. It primarily involves the production of certain antibodies in the body that attack the acetylcholine receptors on the postsynaptic membrane of the neuromuscular junction. This results in the inability of nerve impulses to be effectively transmitted to the muscles, causing the muscles to lose neural control, leading to weakness of the limbs. This weakness is typically more pronounced in the evening than in the morning, with symptoms being lighter upon waking and worsening in the afternoon. As the disease is caused by an autoimmune response, a major focus of treatment is to suppress this abnormal immune reaction, primarily through the administration of corticosteroids. Additionally, many patients with myasthenia gravis also exhibit thymus abnormalities, necessitating thorough CT examinations of the thymus.

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Written by Shi De Quan
Neurology
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If myasthenia gravis is well controlled, will it still recur?

Myasthenia gravis is difficult to control, and even when controlled, it is prone to relapse. The characteristic of myasthenia gravis includes alleviation after rest, and a pattern of alternating episodes and remissions. Since there is no etiological treatment for myasthenia gravis at present, most medications are symptomatic treatments. However, some patients can find relief through plasmapheresis or immunoglobulin therapy, but most patients will experience relapses. Therefore, myasthenia gravis is a disease prone to relapse, and its recurrence is not greatly influenced by how well it is controlled; it depends on the specific circumstances.

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Written by Zhang Hui
Neurology
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Myasthenia gravis should not use what medicine?

Myasthenia gravis is a neuromuscular junction disease in neurology, primarily due to some synaptic dysfunction, leading to pathological fatigue and general weakness in patients. Patients with myasthenia gravis often experience exacerbation of the disease due to fatigue or infection, and certain medications can severely affect synaptic function, worsening the condition, and are therefore not to be used. The medications to avoid mainly include the following types: The first type is aminoglycoside antibiotics, which can exacerbate the transmission at the neuromuscular junction. Second, quinolone antibiotics should also be avoided as much as possible. Third, some antiarrhythmic drugs can also decrease the excitability of the fascia and are not recommended. Additionally, some drugs like morphine, benzodiazepines, and receptor blockers should also be contraindicated or used with caution.