International consensus guidance for management of myasthenia gravis: Executive summary.

Journal Article (Review;Journal Article)


To develop formal consensus-based guidance for the management of myasthenia gravis (MG).


In October 2013, the Myasthenia Gravis Foundation of America appointed a Task Force to develop treatment guidance for MG, and a panel of 15 international experts was convened. The RAND/UCLA appropriateness methodology was used to develop consensus guidance statements. Definitions were developed for goals of treatment, minimal manifestations, remission, ocular MG, impending crisis, crisis, and refractory MG. An in-person panel meeting then determined 7 treatment topics to be addressed. Initial guidance statements were developed from literature summaries. Three rounds of anonymous e-mail votes were used to attain consensus on guidance statements modified on the basis of panel input.


Guidance statements were developed for symptomatic and immunosuppressive treatments, IV immunoglobulin and plasma exchange, management of impending and manifest myasthenic crisis, thymectomy, juvenile MG, MG associated with antibodies to muscle-specific tyrosine kinase, and MG in pregnancy.


This is an international formal consensus of MG experts intended to be a guide for clinicians caring for patients with MG worldwide.

Full Text

Duke Authors

Cited Authors

  • Sanders, DB; Wolfe, GI; Benatar, M; Evoli, A; Gilhus, NE; Illa, I; Kuntz, N; Massey, JM; Melms, A; Murai, H; Nicolle, M; Palace, J; Richman, DP; Verschuuren, J; Narayanaswami, P

Published Date

  • July 2016

Published In

Volume / Issue

  • 87 / 4

Start / End Page

  • 419 - 425

PubMed ID

  • 27358333

Pubmed Central ID

  • PMC4977114

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

International Standard Serial Number (ISSN)

  • 0028-3878

Digital Object Identifier (DOI)

  • 10.1212/wnl.0000000000002790


  • eng