{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:31:17Z","timestamp":1792647077873,"version":"4.5.0"},"reference-count":102,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T00:00:00Z","timestamp":1525132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","theclinics.com","clinicalkey.fr","clinicalkey.com.au","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Neurologic Clinics"],"published-print":{"date-parts":[[2018,5]]},"DOI":"10.1016\/j.ncl.2018.01.011","type":"journal-article","created":{"date-parts":[[2018,4,11]],"date-time":"2018-04-11T18:14:59Z","timestamp":1523470499000},"page":"311-337","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":214,"title":["Treatment of Myasthenia Gravis"],"prefix":"10.1016","volume":"36","author":[{"given":"Constantine","family":"Farmakidis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamatha","family":"Pasnoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen M.","family":"Dimachkie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Barohn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib1","first-page":"73","article-title":"The epidemiology of neuromuscular disorders: a comprehensive overview of the literature","volume":"2","author":"Deenen","year":"2015","journal-title":"J\u00a0Neuromuscul Dis"},{"issue":"5779","key":"10.1016\/j.ncl.2018.01.011_bib2","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/S0140-6736(00)94294-6","article-title":"Treatment of myasthenia gravis with physostigmine","volume":"223","author":"Walker","year":"1934","journal-title":"Lancet"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib3","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1002\/mus.20950","article-title":"Lifetime course of myasthenia gravis","volume":"37","author":"Grob","year":"2008","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.ncl.2018.01.011_bib4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1471-2377-10-46","article-title":"A\u00a0systematic review of population based epidemiological studies in myasthenia gravis","volume":"10","author":"Carr","year":"2010","journal-title":"BMC Neurol"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2165\/00139709-200625020-00004","article-title":"The early toxicology of physostigmine: a tale of beans, great men and egos","volume":"25","author":"Proudfoot","year":"2006","journal-title":"Toxicol Rev"},{"key":"10.1016\/j.ncl.2018.01.011_bib6","unstructured":"Walker MB. The James Lind Library: treatment of myasthenia with Physostigmine. Video of original Mary Walker patient treated with physostigmine. 1934. Available at: http:\/\/www.jameslindlibrary.org\/walker-mb-1934\/. Accessed June 13, 2017."},{"key":"10.1016\/j.ncl.2018.01.011_bib7","first-page":"759","article-title":"Case showing the effect of prostigmin on myasthenia gravis","volume":"28","author":"Walker","year":"1935","journal-title":"Proc R Soc Med"},{"issue":"11","key":"10.1016\/j.ncl.2018.01.011_bib8","first-page":"961","article-title":"Studies in myasthenia gravis; preliminary report on therapy with mestinon bromide","volume":"155","author":"Osserman","year":"1954","journal-title":"J\u00a0Am Med Assoc"},{"issue":"7","key":"10.1016\/j.ncl.2018.01.011_bib9","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1056\/NEJM195408122510706","article-title":"Pyridostigmin (mestinon) in the treatment of myasthenia gravis","volume":"251","author":"Schwab","year":"1954","journal-title":"N\u00a0Engl J Med"},{"issue":"8","key":"10.1016\/j.ncl.2018.01.011_bib10","first-page":"227","article-title":"Mestinon in myasthenia gravis; preliminary report","volume":"15","author":"Tether","year":"1954","journal-title":"Dis Nerv Syst"},{"issue":"10","key":"10.1016\/j.ncl.2018.01.011_bib11","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1212\/WNL.4.10.762","article-title":"Mestinon in the treatment of myasthenia gravis","volume":"4","author":"Westerberg","year":"1954","journal-title":"Neurology"},{"issue":"9","key":"10.1016\/j.ncl.2018.01.011_bib12","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1212\/01.wnl.0000183145.91579.74","article-title":"Nonresponsiveness to anticholinesterase agents in patients with MuSK-antibody-positive MG","volume":"65","author":"Hatanaka","year":"2005","journal-title":"Neurology"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib13","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1002\/mus.21533","article-title":"Clinical findings in MuSK-antibody positive myasthenia gravis: a U.S. experience","volume":"41","author":"Pasnoor","year":"2010","journal-title":"Muscle Nerve"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib14","doi-asserted-by":"crossref","first-page":"e939","DOI":"10.1542\/peds.2013-0814","article-title":"Clinical characteristics of pediatric myasthenia: a surveillance study","volume":"132","author":"VanderPluym","year":"2013","journal-title":"Pediatrics"},{"issue":"10","key":"10.1016\/j.ncl.2018.01.011_bib15","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1136\/bjo.2004.063404","article-title":"Ocular motor dysfunction and ptosis in ocular myasthenia gravis: effects of treatment","volume":"89","author":"Kupersmith","year":"2005","journal-title":"Br J Ophthalmol"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/CND.0b013e31821c5634","article-title":"Ocular myasthenia gravis in an academic neuro-ophthalmology clinic: clinical features and therapeutic response","volume":"13","author":"Mittal","year":"2011","journal-title":"J\u00a0Clin Neuromuscul Dis"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1056\/NEJM197201062860104","article-title":"Benefit from alternate-day prednisone in myasthenia gravis","volume":"286","author":"Warmolts","year":"1972","journal-title":"N\u00a0Engl J Med"},{"issue":"7754","key":"10.1016\/j.ncl.2018.01.011_bib18","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/S0140-6736(72)90520-X","article-title":"Treatment of myasthenia gravis with prednisone","volume":"1","author":"Jenkins","year":"1972","journal-title":"Lancet"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib19","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/ana.410150316","article-title":"Long-term corticosteroid treatment of myasthenia gravis: report of 116 patients","volume":"15","author":"Pascuzzi","year":"1984","journal-title":"Ann Neurol"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib20","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/mus.24769","article-title":"Efficacy of prednisone for the treatment of ocular myasthenia (EPITOME): a randomized, controlled trial","volume":"53","author":"Benatar","year":"2016","journal-title":"Muscle Nerve"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib21","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1111\/j.1600-0404.1998.tb05968.x","article-title":"Treatment of myasthenia gravis with methylprednisolone pulse: a double blind study","volume":"97","author":"Lindberg","year":"1998","journal-title":"Acta Neurol Scand"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib22","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for\u00a0management of myasthenia gravis: executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology"},{"issue":"26","key":"10.1016\/j.ncl.2018.01.011_bib23","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1056\/NEJMra1602678","article-title":"Myasthenia gravis","volume":"375","author":"Gilhus","year":"2016","journal-title":"N\u00a0Engl J Med"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib24","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1056\/NEJM197401102900204","article-title":"Gradually increasing doses of prednisone in myasthenia gravis. Reducing the hazards of treatment","volume":"290","author":"Seybold","year":"1974","journal-title":"N\u00a0Engl J Med"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib25","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1212\/01.wnl.0000312373.67493.7f","article-title":"A\u00a0trial of mycophenolate mofetil with prednisone as initial immunotherapy in myasthenia gravis","volume":"71","year":"2008","journal-title":"Neurology"},{"issue":"24","key":"10.1016\/j.ncl.2018.01.011_bib26","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1212\/01.wnl.0000263481.14289.90","article-title":"Evidence report: the medical treatment of ocular myasthenia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology","volume":"68","author":"Benatar","year":"2007","journal-title":"Neurology"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib27","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1001\/archneur.60.2.243","article-title":"Development of generalized disease at 2 years in patients with ocular myasthenia gravis","volume":"60","author":"Kupersmith","year":"2003","journal-title":"Arch Neurol"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib28","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jns.2003.08.017","article-title":"The effect of prednisone on the progression from ocular to generalized myasthenia gravis","volume":"217","author":"Monsul","year":"2004","journal-title":"J\u00a0Neurol Sci"},{"key":"10.1016\/j.ncl.2018.01.011_bib29","series-title":"Miastenia gravis y trastornos relacionados","first-page":"273","article-title":"Immunomodulatory therapies in myasthenia gravis","author":"Barohn","year":"2017"},{"key":"10.1016\/j.ncl.2018.01.011_bib30","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1749-6632.1981.tb33767.x","article-title":"Effect of immunosuppressive drugs (azathioprine)","volume":"377","author":"Mertens","year":"1981","journal-title":"Ann N Y Acad Sci"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib31","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1002\/ana.410150615","article-title":"Azathioprine in the treatment of myasthenia gravis","volume":"15","author":"Witte","year":"1984","journal-title":"Ann Neurol"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib32","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1212\/WNL.50.6.1778","article-title":"A\u00a0randomized double-blind trial of prednisolone alone or with azathioprine in myasthenia gravis. Myasthenia Gravis Study Group","volume":"50","author":"Palace","year":"1998","journal-title":"Neurology"},{"issue":"8","key":"10.1016\/j.ncl.2018.01.011_bib33","first-page":"449","article-title":"Azathioprine as a single drug or in combination with steroids in the treatment of myasthenia gravis","volume":"235","author":"Mantegazza","year":"1988","journal-title":"J\u00a0Neurol"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib34","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1136\/jnnp.62.2.156","article-title":"Ocular myasthenia gravis: response to long-term immunosuppressive treatment","volume":"62","author":"Sommer","year":"1997","journal-title":"J\u00a0Neurol Neurosurg Psychiatry"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib35","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1212\/WNL.38.2.258","article-title":"Azathioprine toxicity during long-term immunosuppression of generalized myasthenia gravis","volume":"38","author":"Hohlfeld","year":"1988","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib36","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1001\/archinternmed.2007.107","article-title":"Hematologic malignant neoplasms after drug exposure in rheumatoid arthritis","volume":"168","author":"Bernatsky","year":"2008","journal-title":"Arch Intern Med"},{"issue":"12","key":"10.1016\/j.ncl.2018.01.011_bib37","doi-asserted-by":"crossref","first-page":"814","DOI":"10.7326\/0003-4819-154-12-201106210-00009","article-title":"Assessment of thiopurine S-methyltransferase activity in patients prescribed thiopurines: a systematic review","volume":"154","author":"Booth","year":"2011","journal-title":"Ann Intern Med"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib38","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2165\/00002018-199717020-00001","article-title":"Preliminary risk-benefit assessment of mycophenolate mofetil in transplant rejection","volume":"17","author":"Simmons","year":"1997","journal-title":"Drug Saf"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib39","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1212\/WNL.51.3.912-a","article-title":"Successful treatment of a patient with severe refractory myasthenia gravis using mycophenolate mofetil","volume":"51","author":"Hauser","year":"1998","journal-title":"Neurology"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib40","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1212\/WNL.56.1.94","article-title":"Mycophenolate mofetil: a safe and promising immunosuppressant in neuromuscular diseases","volume":"56","author":"Chaudhry","year":"2001","journal-title":"Neurology"},{"issue":"10","key":"10.1016\/j.ncl.2018.01.011_bib41","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1212\/01.WNL.0000094122.88929.0B","article-title":"Mycophenolate mofetil for myasthenia gravis: an analysis of efficacy, safety, and tolerability","volume":"61","author":"Meriggioli","year":"2003","journal-title":"Neurology"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib42","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1212\/01.wnl.0000312374.95186.cc","article-title":"An international, phase III, randomized trial of mycophenolate mofetil in myasthenia gravis","volume":"71","author":"Sanders","year":"2008","journal-title":"Neurology"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib43","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1002\/mus.21640","article-title":"Mycophenolate mofetil in AChR-antibody-positive myasthenia gravis: outcomes in 102 patients","volume":"41","author":"Hehir","year":"2010","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.ncl.2018.01.011_bib44","unstructured":"Mycophenolate REMS risks of first trimester pregnancy loss and congenital malformations. Available at: https:\/\/www.mycophenolaterems.com\/. Accessed January 18, 2018."},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib45","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1212\/01.wnl.0000173031.56429.04","article-title":"Primary CNS lymphoma complicating treatment of myasthenia gravis with mycophenolate mofetil","volume":"65","author":"Vernino","year":"2005","journal-title":"Neurology"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib46","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1002\/mus.21306","article-title":"T-cell lymphoproliferative disorder following mycophenolate treatment for myasthenia gravis","volume":"39","author":"Dubal","year":"2009","journal-title":"Muscle Nerve"},{"issue":"12","key":"10.1016\/j.ncl.2018.01.011_bib47","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1056\/NEJM198703193161205","article-title":"Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis","volume":"316","author":"Tindall","year":"1987","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.ncl.2018.01.011_bib48","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1749-6632.1993.tb22937.x","article-title":"A\u00a0clinical therapeutic trial of cyclosporine in myasthenia gravis","volume":"681","author":"Tindall","year":"1993","journal-title":"Ann N Y Acad Sci"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib49","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1212\/WNL.55.3.448","article-title":"Retrospective analysis of the use of cyclosporine in myasthenia gravis","volume":"55","author":"Ciafaloni","year":"2000","journal-title":"Neurology"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib50","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1159\/000085833","article-title":"Efficacy of low-dose FK506 in the treatment of Myasthenia gravis\u2013a randomized pilot study","volume":"53","author":"Nagane","year":"2005","journal-title":"Eur Neurol"},{"key":"10.1016\/j.ncl.2018.01.011_bib51","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.pediatrneurol.2017.08.014","article-title":"Tacrolimus improves symptoms of children with myasthenia gravis refractory to prednisone","volume":"77","author":"Liu","year":"2017","journal-title":"Pediatr Neurol"},{"issue":"12","key":"10.1016\/j.ncl.2018.01.011_bib52","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1038\/nrrheum.2016.175","article-title":"Mechanism of action of methotrexate in rheumatoid arthritis, and the search for biomarkers","volume":"12","author":"Brown","year":"2016","journal-title":"Nat Rev Rheumatol"},{"key":"10.1016\/j.ncl.2018.01.011_bib53","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1186\/1471-2377-11-97","article-title":"A\u00a0single-blinded trial of methotrexate versus azathioprine as steroid-sparing agents in generalized myasthenia gravis","volume":"11","author":"Heckmann","year":"2011","journal-title":"BMC Neurol"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib54","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1212\/WNL.0000000000002795","article-title":"A\u00a0randomized controlled trial of methotrexate for patients with generalized myasthenia gravis","volume":"87","author":"Pasnoor","year":"2016","journal-title":"Neurology"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib55","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1212\/WNL.31.1.32","article-title":"Stable remissions in myasthenia gravis","volume":"31","author":"Perez","year":"1981","journal-title":"Neurology"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib56","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/mus.10133","article-title":"Use of intravenous pulsed cyclophosphamide in severe, generalized myasthenia gravis","volume":"26","author":"De Feo","year":"2002","journal-title":"Muscle Nerve"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib57","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/ana.10400","article-title":"Treatment of refractory myasthenia: \u201crebooting\u201d with high-dose cyclophosphamide","volume":"53","author":"Drachman","year":"2003","journal-title":"Ann Neurol"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib58","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1002\/mus.25597","article-title":"Rituximab treatment of myasthenia gravis: a systematic review","volume":"56","author":"Tandan","year":"2017","journal-title":"Muscle Nerve"},{"issue":"7","key":"10.1016\/j.ncl.2018.01.011_bib59","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1212\/WNL.55.7.1062-a","article-title":"Rituximab for myasthenia gravis developing after bone marrow transplant","volume":"55","author":"Zaja","year":"2000","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib60","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.4049\/jimmunol.1601415","article-title":"Dysregulation of B cell repertoire formation in myasthenia gravis patients revealed through deep sequencing","volume":"198","author":"Vander Heiden","year":"2017","journal-title":"J\u00a0Immunol"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib61","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/mus.23412","article-title":"Rituximab in refractory and non-refractory myasthenia: a retrospective multicenter study","volume":"46","author":"Collongues","year":"2012","journal-title":"Muscle Nerve"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib62","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1002\/mus.20479","article-title":"Successful treatment of MuSK antibody-positive myasthenia gravis with rituximab","volume":"33","author":"Hain","year":"2006","journal-title":"Muscle Nerve"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib63","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1212\/WNL.0b013e3182407982","article-title":"Long-lasting treatment effect of rituximab in MuSK myasthenia","volume":"78","author":"Diaz-Manera","year":"2012","journal-title":"Neurology"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib64","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1055\/s-0032-1329200","article-title":"Myasthenia gravis","volume":"32","author":"Silvestri","year":"2012","journal-title":"Semin Neurol"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib65","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1212\/CPJ.0000000000000202","article-title":"PML in a patient with myasthenia gravis treated with multiple immunosuppressing agents","volume":"6","author":"Kanth","year":"2016","journal-title":"Neurol Clin Pract"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib66","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1002\/cpt.207","article-title":"Drug-induced progressive multifocal leukoencephalopathy: lessons learned from contrasting natalizumab and rituximab","volume":"98","author":"Vermeer","year":"2015","journal-title":"Clin Pharmacol Ther"},{"key":"10.1016\/j.ncl.2018.01.011_bib67","unstructured":"Nowak R, Coffey C, Goldstein J, et\u00a0al. A phase 2 trial of rituximab in myasthenia gravis: study update. 14th International Congress on Neuromuscular Diseases (ICNMD XIV). Toronto (Canada), July 7, 2016."},{"issue":"8000","key":"10.1016\/j.ncl.2018.01.011_bib68","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0140-6736(76)91917-6","article-title":"Remission of myasthenia gravis following plasma-exchange","volume":"2","author":"Pinching","year":"1976","journal-title":"Lancet"},{"issue":"21","key":"10.1016\/j.ncl.2018.01.011_bib69","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1056\/NEJM197711242972102","article-title":"Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis","volume":"297","author":"Dau","year":"1977","journal-title":"N\u00a0Engl J Med"},{"issue":"8","key":"10.1016\/j.ncl.2018.01.011_bib70","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1212\/WNL.35.8.1096","article-title":"Plasmapheresis and acute Guillain-Barre syndrome. The Guillain-Barre syndrome Study Group","volume":"35","year":"1985","journal-title":"Neurology"},{"issue":"13","key":"10.1016\/j.ncl.2018.01.011_bib71","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1212\/WNL.0b013e31824de293","article-title":"Evidence-based guideline: intravenous immunoglobulin in the treatment of neuromuscular disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology","volume":"78","author":"Patwa","year":"2012","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib72","article-title":"Plasma exchange for myasthenia gravis","author":"Gajdos","year":"2002","journal-title":"Cochrane Database Syst Rev"},{"issue":"23","key":"10.1016\/j.ncl.2018.01.011_bib73","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1212\/WNL.0b013e31821e5505","article-title":"Comparison of IVIg and PLEX in patients with myasthenia gravis","volume":"76","author":"Barth","year":"2011","journal-title":"Neurology"},{"issue":"11","key":"10.1016\/j.ncl.2018.01.011_bib74","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1212\/01.wnl.0000256698.69121.45","article-title":"IV immunoglobulin in patients with myasthenia gravis: a randomized controlled trial","volume":"68","author":"Zinman","year":"2007","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib75","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1002\/mus.23626","article-title":"Safety of plasma exchange therapy in patients with myasthenia gravis","volume":"47","author":"Ebadi","year":"2013","journal-title":"Muscle Nerve"},{"issue":"12","key":"10.1016\/j.ncl.2018.01.011_bib76","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1111\/j.1468-1331.2009.02729.x","article-title":"Changes in serum cytokine levels during plasmapheresis in patients with myasthenia gravis","volume":"16","author":"Yeh","year":"2009","journal-title":"Eur J Neurol"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib77","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1002\/mus.21924","article-title":"Outcome of plasmapheresis in myasthenia gravis: delayed therapy is not favorable","volume":"43","author":"Mandawat","year":"2011","journal-title":"Muscle Nerve"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib78","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/jamaneurol.2014.17","article-title":"Comparison of plasmapheresis and intravenous immunoglobulin as maintenance therapies for juvenile myasthenia gravis","volume":"71","author":"Liew","year":"2014","journal-title":"JAMA Neurol"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib79","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1002\/jca.20143","article-title":"Complications of therapeutic plasma exchange: a prospective study of 1,727 procedures","volume":"22","author":"Shemin","year":"2007","journal-title":"J\u00a0Clin Apher"},{"key":"10.1016\/j.ncl.2018.01.011_bib80","unstructured":"Ahmed F, Vamanan K, Dimachkie M, et\u00a0al. Arteriovenous fistula venous access for long-term outpatient plasma exchange for neuromuscular disorders. American Academy of Neurology Annual Meeting. Seattle (WA), April 25 - May 02, 2009."},{"issue":"8373","key":"10.1016\/j.ncl.2018.01.011_bib81","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0140-6736(84)90469-0","article-title":"High-dose intravenous gammaglobulin for myasthenia gravis","volume":"1","author":"Gajdos","year":"1984","journal-title":"Lancet"},{"issue":"7","key":"10.1016\/j.ncl.2018.01.011_bib82","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1001\/archinte.1986.00360190143020","article-title":"High-dose intravenous immunoglobulin in the management of myasthenia gravis","volume":"146","author":"Arsura","year":"1986","journal-title":"Arch Intern Med"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib83","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/(SICI)1097-4598(200004)23:4<551::AID-MUS14>3.0.CO;2-O","article-title":"Immunoglobulin treatment in refractory myasthenia gravis","volume":"23","author":"Achiron","year":"2000","journal-title":"Muscle Nerve"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib84","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1002\/mus.10224","article-title":"Randomized, controlled trial of intravenous immunoglobulin in myasthenia gravis","volume":"26","author":"Wolfe","year":"2002","journal-title":"Muscle Nerve"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib85","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/ana.410410615","article-title":"Clinical trial of plasma exchange and high-dose intravenous immunoglobulin in myasthenia gravis. Myasthenia Gravis Clinical Study Group","volume":"41","author":"Gajdos","year":"1997","journal-title":"Ann Neurol"},{"issue":"11","key":"10.1016\/j.ncl.2018.01.011_bib86","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1001\/archneur.62.11.1689","article-title":"Treatment of myasthenia gravis exacerbation with intravenous immunoglobulin: a randomized double-blind clinical trial","volume":"62","author":"Gajdos","year":"2005","journal-title":"Arch Neurol"},{"issue":"19","key":"10.1016\/j.ncl.2018.01.011_bib87","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1001\/jama.291.19.2367","article-title":"Intravenous immunoglobulin in autoimmune neuromuscular diseases","volume":"291","author":"Dalakas","year":"2004","journal-title":"JAMA"},{"issue":"3","key":"10.1016\/j.ncl.2018.01.011_bib88","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1212\/WNL.47.3.674","article-title":"Complications of intravenous immune globulin treatment in neurologic disease","volume":"47","author":"Brannagan","year":"1996","journal-title":"Neurology"},{"issue":"4","key":"10.1016\/j.ncl.2018.01.011_bib89","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0303-8467(93)90103-N","article-title":"Soluble terminal complement components in human myasthenia gravis","volume":"95","author":"Barohn","year":"1993","journal-title":"Clin Neurol Neurosurg"},{"key":"10.1016\/j.ncl.2018.01.011_bib90","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1749-6632.1987.tb51301.x","article-title":"The membrane attack complex of complement at the endplate in myasthenia gravis","volume":"505","author":"Engel","year":"1987","journal-title":"Ann N Y Acad Sci"},{"issue":"5","key":"10.1016\/j.ncl.2018.01.011_bib91","first-page":"267","article-title":"Immune complexes (IgG and C3) at the\u00a0motor end-plate in myasthenia gravis: ultrastructural and light microscopic localization and electrophysiologic correlations","volume":"52","author":"Engel","year":"1977","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib92","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1002\/mus.23839","article-title":"A\u00a0randomized, double-blind, placebo-controlled phase II study of eculizumab in patients with refractory generalized myasthenia gravis","volume":"48","author":"Howard","year":"2013","journal-title":"Muscle Nerve"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib93","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1212\/WNL.55.1.7","article-title":"Practice parameter: thymectomy for autoimmune myasthenia gravis (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology","volume":"55","author":"Gronseth","year":"2000","journal-title":"Neurology"},{"issue":"10","key":"10.1016\/j.ncl.2018.01.011_bib94","article-title":"Thymectomy for non-thymomatous myasthenia gravis","author":"Cea","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib95","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1212\/WNL.55.1.3","article-title":"Treatment of myasthenia gravis: a call to arms","volume":"55","author":"Kissel","year":"2000","journal-title":"Neurology"},{"issue":"6","key":"10.1016\/j.ncl.2018.01.011_bib96","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1056\/NEJMoa1602489","article-title":"Randomized trial of thymectomy in myasthenia gravis","volume":"375","author":"Wolfe","year":"2016","journal-title":"N\u00a0Engl J Med"},{"issue":"7","key":"10.1016\/j.ncl.2018.01.011_bib97","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1111\/j.1468-1331.2010.03019.x","article-title":"Guidelines for treatment of autoimmune neuromuscular transmission disorders","volume":"17","author":"Skeie","year":"2010","journal-title":"Eur J Neurol"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib98","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.jpedsurg.2014.10.005","article-title":"Thymectomy for myasthenia gravis in children: a comparison of open and thoracoscopic approaches","volume":"50","author":"Goldstein","year":"2015","journal-title":"J\u00a0Pediatr Surg"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib99","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jpedsurg.2005.10.006","article-title":"Long-term follow-up after thymectomy for myasthenia gravis: thoracoscopic vs open","volume":"41","author":"Wagner","year":"2006","journal-title":"J\u00a0Pediatr Surg"},{"issue":"1","key":"10.1016\/j.ncl.2018.01.011_bib100","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1212\/WNL.55.1.16","article-title":"Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America","volume":"55","author":"Jaretzki","year":"2000","journal-title":"Neurology"},{"issue":"12","key":"10.1016\/j.ncl.2018.01.011_bib101","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1046\/j.1525-1594.2001.06717.x","article-title":"Immunoglobulin treatment versus plasma exchange in patients with chronic moderate to severe myasthenia gravis","volume":"25","author":"Ronager","year":"2001","journal-title":"Artif Organs"},{"issue":"2","key":"10.1016\/j.ncl.2018.01.011_bib102","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s13311-015-0345-y","article-title":"A\u00a0double-blinded, randomized, placebo-controlled trial to evaluate efficacy, safety, and tolerability of single doses of tirasemtiv in patients with acetylcholine receptor-binding antibody-positive myasthenia gravis","volume":"12","author":"Sanders","year":"2015","journal-title":"Neurotherapeutics"}],"container-title":["Neurologic Clinics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733861918300112?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733861918300112?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T10:29:44Z","timestamp":1534933784000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0733861918300112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5]]},"references-count":102,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["S0733861918300112"],"URL":"https:\/\/doi.org\/10.1016\/j.ncl.2018.01.011","relation":{},"ISSN":["0733-8619"],"issn-type":[{"value":"0733-8619","type":"print"}],"subject":[],"published":{"date-parts":[[2018,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Treatment of Myasthenia Gravis","name":"articletitle","label":"Article Title"},{"value":"Neurologic Clinics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ncl.2018.01.011","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}