Myasthenic crisis (MC) is one of the important and common complications in the natural history of myasthenia gravis. MC may be defined as respiratory failure or delayed postoperative extubation for more than 24 hours resulting from myasthenic weakness. MC results from weakness of upper airway muscles leading to obstruction and aspiration, weakness of respiratory muscles leading to reduced tidal volumes, or from weakness of both muscle groups. Common precipitating factors for MC include respiratory infections, aspiration, sepsis, surgical procedures, rapid tapering of immune modulation agents, starting corticosteroids treatment, exposure to drugs that may increase myasthenic weakness, and pregnancy. MC is a serious occurrence, affecting up to 12-16% of patients with myasthenia gravis. Moreover, MC is a potentially life-threatening complication of myasthenia gravis that requires aggressive therapy. In patients with MC, both therapeutic options, plasma exchange and intravenous immunoglobulin, are equally effective in disease stabilization.

Myasthenic crisis Intravenous immunoglobulin Plasma exchange