DURING THE past 3 decades, the therapeutic options for patients with neuromuscular transmission disorders have greatly increased. However, debate continues on the best approach to both short-term and long-term management. Although therapies have decreased mortality, the clinical course continues to present problems for most patients. No mode of therapy has been proven to be clearly superior; therefore, the choice of therapy should focus on the individual patient.
Several factors determine the type of therapy that is most appropriate for a given patient. Ideally, the therapy should have minimal adverse effects, be easy to use, and be inexpensive. Therapeutic decisions in an acute setting are based on the patient's rate of disease progression, distribution of weakness, and confounding medical factors. Long-term therapeutic decisions are based on the patient's age, sex, and the presence of other diseases. The presence or absence of thymoma in patients with myasthenia gravis also influences the immediate treatment plan and long-term therapeutic regimen.
J. Ned Pruitt II, Thomas R. Swift. Therapies for Disorders of the Neuromuscular Junction. Arch Neurol. 2002;59(5):739–742. doi:10.1001/archneur.59.5.739