Walsh & Hoyt: Pediatric Myasthenia Gravis

Autoimmune MG can occur at any age. One clinical challenge in ""juvenile-onset"" myasthenia is to distinguish antibody-mediated disease from gene mutations affecting NMJ ion channels. Juvenile-onset autoimmune MG differs little from adult-onset disease, except that it may improve with age. It responds to anticholinesterase agents and immunotherapy. Amblyopia may occur with extraocular muscle involvement and must be prevented by careful ophthalmologic follow-up. The optimal age for thymectomy and the choice of immunosuppressive agents in such young patients is controversial.