Immunosuppressive therapy should be maintained throughout pregnancy, as this reduces the chance of neonatal muscle weakness, and controls the mothers myasthenia.About 10–20% of infants with mothers affected by the condition are born with transient neonatal myasthenia (TNM), which generally produces feeding and respiratory difficulties that develop about 12 hours to several days after birth. A child with TNM typically responds very well to acetylcholinesterase inhibitors, and the condition generally resolves over a period of three weeks, as the antibodies diminish, and generally does not result in any complications. Very rarely, an infant can be born with arthrogryposis multiplex congenita, secondary to profound intrauterine weakness. This is due to maternal antibodies that target an infants acetylcholine receptors. In some cases, the mother remains asymptomatic. Diagnosis
MG can be difficult to diagnose, as the symptoms can be subtle and hard to distinguish from both normal variants and other neurological disorders.Three types of myasthenic symptoms in children can be distinguished:
Transient neonatal myasthenia occurs in 10 to 15% of babies born to mothers afflicted with the disorder, and disappears after a few weeks. Congenital myasthenia, the rarest form, occurs when genes are present from both parents. Juvenile myasthenia gravis is most common in females.Congenital myasthenias cause muscle weakness and fatigability similar to those of MG. The signs of congenital myasthenia usually are present in the first years of childhood, although they may not be recognized until adulthood. Classification
When diagnosed with MG, a person is assessed for his or her neurological status and the level of illness is established.
After the addition of pathogenic antibodies against the acetylcholine receptor and activation of the complement system, the neuromuscular co-culture shows symptoms such as weaker muscle contractions. References
Further reading
Zhang Z, Guo J, Su G, Li J, Wu H, Xie X (17 November 2014). "Evaluation of the quality of guidelines for myasthenia gravis with the AGREE II instrument". PLOS ONE. 9 (11): e111796. Bibcode:2014PLoSO...9k1796Z. doi:10.1371/journal.pone.0111796. PMC 4234220. PMID 25402504. "NCBI – Diagnostic". www.ncbi.nlm.nih.gov. Retrieved 11 July 2015.