What is the mainstay of treatment for Myasthenia gravis?

The mainstay of treatment for Myasthenia gravis is cholinesterase inhibitors. These medications, such as pyridostigmine, work by blocking the enzyme that breaks down acetylcholine, which is crucial for communication between nerves and muscles. In Myasthenia gravis, the body produces antibodies that disrupt the normal functioning of acetylcholine receptors at the neuromuscular junction, leading to muscle weakness. By preventing the breakdown of acetylcholine, cholinesterase inhibitors increase the availability of this neurotransmitter, thereby improving communication between nerves and muscles and enhancing muscle strength and endurance.

Cholinesterase inhibitors are typically the first line of treatment because they address the underlying problem by improving neuromuscular transmission, making them a fundamental aspect of managing Myasthenia gravis. While other treatments, such as corticosteroids and monoclonal antibodies, may also be used in certain cases or for specific patient populations, they generally serve as adjunctive therapies or for patients with more severe symptoms. Surgery, specifically a thymectomy, may be considered in some patients but is not universally indicated for all individuals with this condition.