Key messages

• Myasthenia gravis is an autoimmune disease which causes muscle weakness.

• The anti-acetylcholine receptor antibody causes a marked reduction of acetylcholine receptor density in the post-junctional membrane.

• There is a reduction in the safety margin for neuromuscular transmission which accounts for the fatiguable muscle weakness.

• Symptomatic improvement in muscle power can occur with anticholinesterase medication.

• Removal of the thymus gland often produces a reduction in anti-acetylcholine receptor antibody and an improvement in symptoms. Introduction

Myasthenia gravis is a disorder of neuromuscular transmission. The disease is brought about through the action of a circulating antibody which dramatically reduces the density of acetylcholine receptors on the postjunctional membrane of the neuromuscular junction ( New,s,om:iDavisii1992; Drachman 1994).

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