Title : Myasthenia Gravis: The importance of staging and progression assessment
Abstract:
Myasthenia Gravis (MG) is a chronic autoimmune disorder affecting the neuromuscular junction, resulting in muscle weakness and fatigue. Evaluating the progression of MG is critical for effective management and is often accomplished through the use of various scales. These scales assist in categorizing symptom severity and guiding therapeutic decisions. MG can be classified into different stages or classes, ranging from mild ocular symptoms to severe generalized weakness impacting respiratory muscles. Controlled MG refers to a state in which symptoms are well-managed, with minimal interference in daily activities. In contrast, refractory MG is characterized by persistent symptoms despite optimized treatment. Minimal symptoms denote near-normal function with occasional mild weakness (MGADL score < 2).
The presence of distinct antibodies, such as anti-acetylcholine receptor (AChR) and anti-muscle-specific kinase (MuSK) antibodies, may influence disease severity and treatment response. Patient involvement in therapeutic decision-making is vital, as it ensures that treatment plans align with individual preferences and lifestyles, thereby enhancing adherence and improving outcomes. Regular assessments using standardized scales, an understanding of antibody-related differences, and active patient participation are essential for optimizing MG management.
In our cohort of 131 regularly monitored MG patients, approximately 20% have experienced at least one episode of myasthenic crisis. However, at present, only 15% exhibit an MGADL score exceeding 5 points, despite the majority of patients achieving a high MGQOL score.
