Myasthenic Crisis (MC)
Myasthenic Crisis (MC)
General and supportive measures
G70.01
DESCRIPTION
Acute onset of respiratory failure due to worsening myasthenia gravis, requiring ICU admission. Respiratory and bulbar insufficiency is common with an inability to breathe or swallow or may have worsening of existing symptoms. MC is most frequently precipitated by systemic infections.
| Myasthenic crisis may be the initial presentation. |
DIAGNOSTIC CRITERIA
Clinical
- Worsening of existing weakness.
- Respiratory compromise.
- Inability to swallow.
GENERAL AND SUPPORTIVE MEASURES
- Admit to ICU for close observation.
- Provide ventilatory and feeding support as required.
MEDICINE TREATMENT
For consideration of glucocorticoid therapy and intravenous immunoglobulin, in discussion with neurologist.
- Dexamethasone, IV or IM,
- Immunoglobulin, IV, 1 g/kg/day, slowly over 12–16 hours on two consecutive days or 0.4 g/kg as a single daily dose on 5 consecutive days early in the disease process.
REFERRAL
- All cases for further management.
Click here to access NEMLC Report.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Paediatric Hospital Level_Updated May 2025
Chapter 13: The Nervous System_13.7 Neuromuscular Disorders_13.7.2 Myasthenia Gravis_13.7.2.1 Myasthenic Crisis (MC)