Update on the evaluation and therapy of autoimmune neuromuscular junction disorders.
Many recent strides have increased our understanding of the immune-mediated diseases of neuromuscular junction transmission. Nevertheless, patients with myasthenia gravis and the Lambert-Eaton myasthenic syndrome often present diagnostic and therapeutic challenges to clinicians. Both conditions have a wide range of clinical presentations and the number of treatment modalities available to these patients continues to increase. This creates a need for an individualized approach for managing these patients. Other important controversies exist because the benefits of some treatments are not firmly established by clinical trials. After a brief review of the pertinent scientific basis of these diseases, we focus on present issues governing the clinical evaluation and management of myasthenia gravis and the Lambert-Eaton myasthenic syndrome.
Katz
J
J
Department of Neurology, Stanford University Medical Center, Palo Alto, California, USA. jskatz@stanford.edu
Barohn
R J
RJ
D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004568:Electrodiagnosis / Q000379:methods; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D020511:Neuromuscular Junction Diseases / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D026741:Physical Therapy Modalities / Q000379:methods; D011379:Prognosis