Juvenile myasthenia gravis (JMG): treatment

Evidence-based neurology checklist on juvenile myasthenia gravis (jmg): treatment: Pyridostigmine The starting dose is 0.5–1 mg/kg 3-4 times daily The dose can be increased up to 1.5 mg/kg 5 times daily day The maximum dose is 450 mg daily Consider immunosuppression if severe symptoms persist at 1…

Pyridostigmine

  • The starting dose is 0.5–1 mg/kg 3-4 times daily
  • The dose can be increased up to 1.5 mg/kg 5 times daily day
  • The maximum dose is 450 mg daily
  • Consider immunosuppression if severe symptoms persist at 1 mg/kg 4 times daily
  • Also see Neurochecklist: “Myasthenia gravis MG treatment: pyridostigmine”

First line immunosuppression: Prednisolone

Second line immunosuppression: agents

Second line immunosuppression: indications

Thymectomy

Treatment of myasthenic crisis

References

  1. O'Connell K, Ramdas S, Palace J. Management of juvenile myasthenia gravis. Front Neurol 2020; 11:743. 
  2. Ramdas S, Della Marina A, Ryan MM, et al. Rituximab in juvenile myasthenia gravis-an international cohort study and literature review. Eur J Paediatr Neurol 2022; 40:5-10. 
  3. Molimard A, Gitiaux C, Barnerias C, et al. Rituximab therapy in the treatment of juvenile myasthenia gravis: the French experience. Neurology 2022; 98:e2368-e2376.
  4. Madenci AL, Li GZ, Weil BR, Zurakowski D, Kang PB, Weldon CB. The role of thymectomy in the treatment of juvenile myasthenia gravis: a systematic review. Pediatr Surg Int 2017; 33:683-694.
  5. Zhang Q, Cao Y, Bi Z, et al. Childhood-onset myasthenia gravis patients benefited from thymectomy in a long-term follow-up observation. Eur J Pediatr Surg 2022; 32:543-549.

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