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Myasthenia Gravis

Steroid treatment

06/19/2009

Question:

Over the past few months I have been experiencing numerous symptoms related to MG but the doctors remain uncertain in making a clear diagnosis. While hospitalized I was on steroids for a 3 day period to see how my symptoms would react but there was no significant change. Would my body have required a longer time in adjusting to the steroids in order to respond w/ positive change? Do all MG patients respond to steroid treatment?

Answer:

Steroids for less than two weeks is not a usual treatment regimen, nor is there good literature to give you advice about how effective this might be. There is pulse dosing Solumederol, but usually someone ends up on a prednisone oral taper afterwards. I would be careful about calling three days of prednisone a "failure" if there is no response. Not all myasthenic patients respond to steroids, but the majority of autoimmune myasthenia patients do respond to steroids. Up to 2/3 of patients in the older studies respond to prednisone when used for longer than 3 months. Some require more aggressive immunosuppression, in addition. Always look back to the symptoms and are they myasthenic symptoms.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati