Management of myasthenic conditions: nonimmune issues

@article{Argov2009ManagementOM,
  title={Management of myasthenic conditions: nonimmune issues},
  author={Zohar Argov},
  journal={Current Opinion in Neurology},
  year={2009},
  volume={22},
  pages={493–497}
}
  • Z. Argov
  • Published 1 October 2009
  • Medicine, Biology
  • Current Opinion in Neurology
Purpose of reviewTo review some management issues in myasthenic disorders that are not part of the immune interventions. These are mainly related to pharmacotherapy of these conditions and side effects of various medications, but also referred to acute management of respiration in myasthenic crises. Recent findingsAntisense compound inhibiting acetylcholine esterase has positive therapeutic effects during short-term administration, but further studies are needed to confirm its chronic effects… 
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References

SHOWING 1-10 OF 30 REFERENCES
Statin-associated exacerbation of myasthenia gravis
TLDR
A patient with well-documented MG is presented who experienced worsening of his condition after taking different statins on four separate occasions, and it is not clear that this patient had MG.
Is it safe to use statins in patients with myasthenia gravis?
  • N. Gilhus
  • Medicine
    Nature Clinical Practice Neurology
  • 2009
TLDR
Patients with MG should be informed about the possibility of MG exacerbation, and the statins should be withdrawn if this occurs, according to a retrospective study in which the consequences of using statins in patients with MG were examined.
Statin-Associated Myasthenia Gravis: Report of 4 Cases and Review of the Literature
TLDR
In 4 patients who developed symptoms of myasthenia gravis within 2 weeks of starting treatment with a statin drug, the drug appears to have exacerbated underlying myastenic weakness, whereas in the other 3 cases, de novo antibody formation appears to be most likely.
The therapy of congenital myasthenic syndromes
  • A. Engel
  • Medicine, Biology
    Neurotherapeutics
  • 2011
Statins may aggravate myasthenia gravis
Statin‐induced myopathy is well‐known, but the effect of cholesterol‐lowering agents on myasthenia gravis (MG) has not been studied in detail. We investigated statin use and its effects on MG among
Anesthesia issues in the perioperative management of myasthenia gravis.
TLDR
Standard anesthetic agents and, if needed, judiciously titrated NMB drugs generally allow safe emergence and immediate extubation for most low-risk MG patients and communication to the patient, family, and other caregivers of the goals of the anesthetic plan and of the patient's evolving status are very important duties of theAnesthesiologist.
More evidence for the association between statins and myasthenia gravis
TLDR
A retrospective case series of 170 myasthenia gravis patients in which 31% were using statins is described, finding that 6 patients had worsening of their MG symptoms after the use of one or more statins.
Noninvasive ventilation in myasthenic crisis.
TLDR
A BiPAP trial before the development of hypercapnia can prevent intubation and prolonged ventilation, reducing pulmonary complications and lengths of intensive care unit and hospital stay.
Myasthenia gravis in pregnancy and birth: identifying risk factors, optimising care
TLDR
Most MG women benefit from being examined by a neurologist during pregnancy, to minimize risks and select the best delivery mode in collaboration with obstetricians.
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2
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