How is a myasthenic crisis treated
After respiratory function is secured, how is a myasthenic crisis treated?
A thorough work-up for intercurrent infection or other acute disease is needed, along with careful review of the patient’s medication list and recent history (for potential agents contributing to Neuromuscular Junction dysfunction or recent changes in Myasthenia gravis treatment regimen).
Temporizing therapy with plasmapheresis or IVIG should be instituted as soon as possible, followed by chronic immunosuppressive therapy if not contraindicated by other intercurrent illness.
If infection is present, IVIG is the temporizing therapy of choice. Anticholinesterases are problematic.
If cholinergic crisis is suspected (i.e., very high daily doses used), anticholinesterases should be discontinued with careful respiratory monitoring.
