From the Research
Recovery from a myasthenic crisis typically takes around 2 weeks, or 12-14 days of ventilation, with proper treatment. This timeline can vary significantly between patients, depending on several factors including the patient's age, overall health status, severity of the crisis, promptness of treatment initiation, and presence of comorbidities 1. Treatment usually involves immediate respiratory support if needed, followed by plasma exchange (PLEX) or intravenous immunoglobulin (IVIG) therapy.
- PLEX is typically administered in 5-6 sessions over 10-14 days,
- while IVIG is given at 2g/kg divided over 2-5 days. During this time, acetylcholinesterase inhibitors like pyridostigmine are often temporarily discontinued until respiratory function improves.
- Immunosuppressive medications such as prednisone, azathioprine, or mycophenolate mofetil may be initiated or adjusted for long-term management. The recovery process involves gradual weaning from ventilatory support, careful medication adjustment, and rehabilitation to restore muscle strength and function. According to a recent study, plasma exchange was associated with a reduced ICU stay length and an early response in patients with AChR subtype myasthenic crisis 2. However, the clinical efficacy was equally comparable in both groups after 1 month. It's essential to note that the treatment should be tailored on an individual basis using the best clinical judgment, taking into account the patient's specific needs and circumstances 3, 4, 5.