What QMGS score indicates severe myasthenia gravis?

QMGS 0-39; mild 20; individual items assess ocular, facial, bulbar, respiratory, and limb muscle groups; FVC testing is essential - FVC <1L or <25% predicted is crisis threshold.

What is the standard pyridostigmine dose for MG?

Pyridostigmine 30-60 mg every 3-4h (max 360-600 mg/day); tablet 60 mg or sustained-release 180 mg nocturnal; overdose causes cholinergic crisis (increased secretions, bradycardia, muscle fasciculations) vs myasthenic crisis (worsening weakness).

When is thymectomy indicated in myasthenia gravis?

Thymectomy recommended for thymoma (urgent removal regardless of MG severity); AChR-positive generalized MG age 18-65 (MGTX trial: improved remission and reduced immunosuppression at 3 years); MuSK-positive MG: less clear benefit.

What triggered exacerbation in MG?

Infections (particularly respiratory), pregnancy (postpartum worst), surgery, certain medications (aminoglycosides, fluoroquinolones, neuromuscular blockers, beta-blockers, calcium channel blockers), stress, and thyroid disease trigger MG exacerbations.

What treatments are used for refractory MG?

Eculizumab (C5 complement inhibitor): approved for AChR-positive refractory generalized MG; efgartigimod (FcRn inhibitor): reduces IgG including AChR antibodies; rozanolixizumab; rituximab for MuSK-positive refractory MG; IVIG/plasma exchange for rapid symptom control.

Myasthenia Gravis Quantitative Score (QMGS) and Crisis Risk

Calculates the Quantitative Myasthenia Gravis Score (QMGS) across 13 test items, myasthenic crisis risk assessment (FVC <1L threshold), pyridostigmine dose optimization, and thymectomy eligibility by AChR antibody status.

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Myasthenia Gravis Quantitative Score (QMGS) and Crisis Risk

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Frequently Asked Questions

What QMGS score indicates severe myasthenia gravis?

What is the standard pyridostigmine dose for MG?

When is thymectomy indicated in myasthenia gravis?

What triggered exacerbation in MG?

What treatments are used for refractory MG?