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Myasthenia Gravis

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Albert and Jakobiec's Principles and Practice of Ophthalmology

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Abstract

Myasthenia gravis (MG) is the prototypical autoimmune antibody-mediated disease characterized by muscle weakness and fatigability. The antibodies cause reduced numbers of available acetylcholine receptors at neuromuscular junctions. In addition to destruction of acetylcholine receptors, they can change the surface membrane clustering of receptors or cause change in the postsynaptic membrane architecture. The final result is impaired neuromuscular transmission.

Generalized myasthenia can affect the limbs, bulbar, facial, and respiratory muscles. The diagnosis of MG can be made in clinic with clinical tests such as the sleep test and ice test. Serological testing for acetylcholine receptor antibodies and for the antibodies to muscle-specific tyrosine kinase and low-density lipoprotein receptor-related protein 4 will be discussed.

Ocular myasthenia gravis is a subtype of myasthenia with weakness that is clinically isolated to the extraocular, levator palpebrae superioris, and orbicularis oculi muscles.

MG is a treatable disease. Thymectomy is indicated for certain subgroups of MG. The treatment of MG has expanded with the usage of newer immune modulating drugs.

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Authors and Affiliations

  1. Department of Neurology, Swedish Neuroscience Institute, Seattle, WA, USA

    Bonnie M. Keung & Steven R. Hamilton

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  1. Bonnie M. Keung
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Correspondence to Bonnie M. Keung .

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Editors and Affiliations

  1. Casey Eye Institute, Oregon Health & Science, Portland, OR, USA

    Daniel M. Albert

  2. Department of Ophthalmology, Massachusetts Eye and Ear, Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Joan W. Miller

  3. Department of Ophthalmology, University of Illinois College of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Dimitri T. Azar

  4. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA

    Lucy H. Young

Section Editor information

  1. McGill University, Montreal, Canada

    Leonard Levin

  2. Massachusetts Eye and Ear, Boston, USA

    Dean Cestari

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Keung, B.M., Hamilton, S.R. (2022). Myasthenia Gravis. In: Albert, D.M., Miller, J.W., Azar, D.T., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-030-42634-7_54

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