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The myasthenic patient in crisis: an update of the management in Neurointensive Care Unit

2013/09/01 by Daniel Agustín Godoy, Leonardo Jardim Vaz de Mello, Luca Masotti +1 · 1 citation
Medicine · #Myasthenia Gravis and Thymoma #Parkinson's Disease and Spinal Disorders #Peripheral Neuropathies and Disorders

paper · pdf · doi:10.1590/0004-282x20130108

openalex publication_date 2013/09/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/31

Abstract

Myasthenia gravis (MG) is an autoimmune disorder affecting neuromuscular transmission leading to generalized or localized muscle weakness due most frequently to the presence of autoantibodies against acetylcholine receptors in the postsynaptic motor end-plate. Myasthenic crisis (MC) is a complication of MG characterized by worsening muscle weakness, resulting in respiratory failure that requires intubation and mechanical ventilation. It also includes postsurgical patients, in whom exacerbation of muscle weakness from MG causes a delay in extubation. MC is a very important, serious, and reversible neurological emergency that affects 20-30% of the myasthenic patients, usually within the first year of illness and maybe the debut form of the disease. Most patients have a predisposing factor that triggers the crisis, generally an infection of the respiratory tract. Immunoglobulins, plasma exchange, and steroids are the cornerstones of immunotherapy. Today with the modern neurocritical care, mortality rate of MC is less than 5%.

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