Myasthenia Gravis | Diagnosis and Treatment

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How is myasthenia gravis diagnosed?

The first step in diagnosing this condition is a physical exam, during which your child's clinician will take your child’s complete medical history and may ask about your family history.

The clinician may also order one or more of the following tests:

  • Antibody titer tests to see if antibodies are attacking your child’s neuromuscular system. If these tests are positive, it is likely that your child has myasthenia gravis.
  • Repetitive nerve stimulation is another way of diagnosing the condition. It is performed during an electromyography study (EMG) and involves stimulating specific nerves and examining abnormal muscle movements.
  • Tensilon tests are sometimes used to confirm a diagnosis of myasthenia gravis. During this test, your child will get an injection of a small amount of a medicine called Tensilon. If your child has myasthenia gravis, there will be an immediate, brief increase in muscle tone.
  • Stimulated single fiber EMG (SSFEMG) is a specialized test that is also performed in the EMG laboratory. It is sometimes used when other tests are negative or inconclusive.

What are the treatments for myasthenia gravis?

Although myasthenia gravis can't be cured, there are several treatment options that can help strengthen muscles, manage symptoms and prolong symptom-free periods.

Depending on your child’s specific needs, he or she may receive one or more types of treatment.

Medications

Several types of medications are used to help reduce the symptoms of myasthenia gravis.

  • Acetylcholinesterase inhibitors. These medications work well for some children with mild symptoms.
  • Immunomodulatory therapy. These medications help reduce the quantity of harmful antibodies in the body. They may include plasmapheresis, intravenous immunoglobin (IVIG) and steroids.

Surgery

Children whose symptoms don’t improve with medication, or those who are heavily dependent on medication, may benefit from a surgery called thymectomy. This is the removal of the thymus, a gland in the chest that has been linked with production of the harmful antibodies.

This procedure can work very well in some, though not all, cases. Some children who have this surgery do have significant improvement.

Expert care for myasthenia gravis

Our staff at the Boston Children's Hospital Neuromuscular Center is dedicated to treating children with myasthenia gravis and developing the best treatment plans to manage this condition.

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