Immunosuppression with steroids such as prednisolone is effective in decreasing anti-acetylcholine receptor antibody levels and improving clinical state in the majority of patients with myasthenia gravis. An alternate-day steroid regimen is used starting with a low dose of prednisolone (e.g. 5 mg) and then increasing the alternate-day dose by 5 mg each week until a maintenance dose of l mg/kg on alternate days is reached. This dose is then maintained until the patient has been in remission for several months. The steroids are then reduced slowly over months until a minimum effective dose is achieved. Starting with a high dose of steroid or increasing the dose too fast may cause a deterioration of muscle power before improvement begins (Pascuzzi et al 19.84). However, remission is achieved faster. If a high-dose regimen is contemplated, the patient is best managed in an intensive care environment where respiratory support is rapidly available.

Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

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