For refractory cases of Myasthenia Gravis, what treatments are often used?

In refractory cases of Myasthenia Gravis, intravenous immunoglobulin (IVIG) and plasmapheresis are often utilized as treatments due to their ability to quickly reduce the number of circulating antibodies that interfere with neuromuscular transmission. Myasthenia Gravis is an autoimmune disorder characterized by weakness and rapid fatigue of voluntary muscles, and in difficult cases where standard treatments, such as oral steroids or acetylcholinesterase inhibitors, are not effective, these therapies can provide significant relief.

IVIG works by modulating the immune response, thereby decreasing the production of harmful antibodies. This can lead to temporary improvement in muscle strength. Plasmapheresis, on the other hand, is a process that removes antibodies directly from the bloodstream, allowing for rapid improvement in symptoms. Both methods offer short-term benefits and are especially valuable in managing acute exacerbations or preparing a patient for surgery, particularly a thymectomy, which can also improve symptoms in certain patients with Myasthenia Gravis.

The other options, which include intensive physical therapy, oral steroids alone, and over-the-counter pain relievers, do not address the underlying autoimmune process effectively in refractory cases. While staples like oral steroids can help to manage symptoms, they may not be