Treatment is by medication and/or surgery. Medication consists mainly of acetylcholinesterase inhibitors to directly improve muscle function and immunosuppressant drugs to reduce the autoimmune process. Thymectomy is a surgical method to treat<unk> . Medication Neostigmine, chemical structure Azathioprine, chemical structure Worsening may occur with medication such as fluoroquinolones, aminoglycosides, and magnesium. About 10% of people with generalized<unk>  are considered treatment-refractory. Autologous hematopoietic stem cell transplantation (HSCT) is sometimes used in severe, treatment-refractory<unk> . Available data provide preliminary evidence that HSCT can be an effective therapeutic option in carefully selected cases. Efgartigimod alfa was approved for medical use in the United States in December 2021. Acetylcholinesterase inhibitors Acetylcholinesterase inhibitors can provide symptomatic benefit and may not fully remove a person's weakness from<unk> . While they might not fully remove all symptoms of<unk> , they still may allow a person the ability to perform normal daily activities. Usually, acetylcholinesterase inhibitors are started at a low dose and increased until the desired result is achieved. If taken 30 minutes before a meal, symptoms will be mild during eating, which is helpful for those who have difficulty swallowing due to their illness. Another medication used for<unk> , atropine, can reduce the muscarinic side effects of acetylcholinesterase inhibitors. Pyridostigmine is a relatively long-acting drug (when compared to other cholinergic agonists), with a half-life around four hours with relatively few side effects. Generally, it is discontinued in those who are being mechanically ventilated, as it is known to increase the amount of salivary secretions. A few high-quality studies have directly compared cholinesterase inhibitors with other treatments (or placebo); their practical benefit may be such that conducting studies in which they would be withheld from some people would be difficult. Immune suppressants The steroid prednisone might also be used to achieve a better result, but it can lead to the worsening of symptoms for 14 days and takes 6–8 weeks to achieve its maximal effectiveness. Due to the myriad symptoms that steroid treatments can cause, it is not the preferred method of treatment. Other immune suppressing medications may also be used including rituximab. Plasmapheresis and IVIG If the<unk>  is serious <unk>  crisis), plasmapheresis can be used to remove the putative antibodies from the circulation. Also, intravenous immunoglobulins (IVIGs) can be used to bind the circulating antibodies. Both of these treatments have relatively short-lived benefits, typically measured in weeks, and often are associated with high costs, which make them prohibitive; they are generally reserved for when<unk>  requires hospitalization. Surgery As thymomas are seen in 10% of all people with the<unk> , they are often given a chest X-ray and CT scan to evaluate their need for surgical removal of their thymus glands and any cancerous tissue that may be present. Even if surgery is performed to remove a thymoma, it generally does not lead to the remission of<unk> . Surgery in the case of<unk>  involves the removal of the thymus, although in 2013, no clear benefit was indicated except in the presence of a thymoma. A 2016 randomized, controlled trial, however, found some benefits. Physical measures People with<unk>  should be educated regarding the fluctuating nature of their symptoms, including weakness and exercise-induced fatigue. Exercise participation should be encouraged with frequent rest. In people with generalized<unk> , some evidence indicates a partial home program including training in diaphragmatic breathing, pursed-lip breathing, and interval-based muscle therapy may improve respiratory muscle strength, chest wall mobility, respiratory pattern, and respiratory endurance. Medical imaging In people with<unk> , older forms of iodinated contrast used for medical imaging have caused an increased risk of exacerbation of the disease, but modern forms have no immediate increased risk.
Myasthenia gravis
Guillain–Barré syndrome
Congenital myasthenic syndrome
Botulism
Neurasthenia
Organophosphate poisoning
Polymyositis
Brainstem stroke syndrome