What is the initial treatment for myasthenia gravis?

The initial treatment for myasthenia gravis primarily involves the use of anticholinesterase inhibitors, which work by increasing the availability of acetylcholine at the neuromuscular junction. This helps to alleviate the weakness and fatigue that characteristic symptoms of the condition.

Anticholinesterase inhibitors, such as pyridostigmine, enhance cholinergic transmission by preventing the breakdown of acetylcholine, thereby improving communication between nerve and muscle. This is particularly important for patients with myasthenia gravis, whose muscle weakness results from an autoimmune attack on the acetylcholine receptors at the neuromuscular junction.

While other treatment options, such as intravenous immunoglobulin, corticosteroids, and plasmapheresis, are useful for managing severe exacerbations or when quick symptom relief is needed, they are generally not the first line of treatment for initial management. Anticholinesterase inhibitors provide a more immediate and consistent approach to addressing the underlying weakness. Thus, they are considered the cornerstone of treatment in newly diagnosed myasthenia gravis patients.