Present Status of Therapy in Myasthenia Gravis

The neuromuscular disorder known as myasthenia gravis was first described by Willis in the 17th century. The clinical features were more distinctly outlined by Erb in 1878, and the periods of remission were emphasized by Goldflam, so that the condition frequently has been referred to as Erb-Goldflam's disease. Since this article is designed to focus attention on the present status of therapy in myasthenia gravis, there will be no effort made to consider in detail the pathology and symptomatology of this disease. For a comprehensive survey of these aspects, reference may be made to the excellent review by Keschner and Strauss. 1 The chief clinical feature of myasthenia gravis is muscle fatigability on sustained effort. The initial symptoms most often appear in the extraocular muscles, producing ptosis and a variable diplopia. The extraocular muscle involvement may be so severe as to produce a complete external ophthalmoplegia (Fig. 1 A ). Weaknesses