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Cureus 2022 Mar 17;14(3):e23251. Epub 2022 Mar 17.

Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, University of Nairobi, Nairobi, KEN.

A myasthenic crisis is a severe, life-threatening exacerbation of myasthenia gravis that causes a rapid onset of muscle weakness and fatigue that may result in tetraparesis, dyspnea, respiratory insufficiency, aspiration, and death. Bulbar muscle functions are markedly affected resulting in depressed cough reflex, swallowing, and speech. Thus, mechanical ventilation, supportive feeding, and critical care are essential for the survival of patients in a myasthenic crisis. Read More

Med Lett Drugs Ther 2022 04;64(1648):62-63

PLoS One 2022 31;17(3):e0266203. Epub 2022 Mar 31.

Department of Gynaecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Background: The loss of one or more pregnancies before viability (i.e. pregnancy loss or miscarriage), has been linked to an increased risk of diseases later in life such as myocardial infarction and stroke. Read More

Ideggyogy Sz 2022 Mar;75(3-04):141-144

Kütahya Health Sciences University Faculty of Medicine, Department of Neurology, Turkey.

Myasthenia gravis (MG) is an autoimmune disease that is characterised by the formation of antibodies against acetylcholine receptors in the postsynaptic membrane of the neuromuscular junction. The course of the disease cannot be predicted during pregnancy. A subtype of MG with positive muscle-specific receptor tyrosine kinase (anti-MuSK) antibodies exhibits more localised clinical characteristics and a poor response to treatment compared with the disease subtype that involves positivity for acetylcholine receptor antibodies. Read More

Case Rep Womens Health 2022 Apr 23;34:e00406. Epub 2022 Mar 23.

PA Program, University of Texas Medical Branch at Galveston School of Medicine, Galveston, TX, USA.

A 16-year-old primigravida was diagnosed with COVID-19 in her second trimester. She decompensated quickly and had to be admitted to hospital and intubated. She was diagnosed with a fetal demise after being intubated and neurology suspected myasthenia gravis due to neurologic symptoms. Read More

Orphanet J Rare Dis 2022 02 16;17(1):52. Epub 2022 Feb 16.

Huashan Rare Disease Center, Department of Neurology, Huashan Hospital, Fudan University, 200040, Shanghai, China.

Objective: Myasthenia gravis (MG) is an autoimmune disorder that frequently affects females at reproductive age. Herein, we aimed to assess the associations of clinical factors with pregnancy-related outcome in MG.

Methods: We searched PubMed and EMBASE for case-control and cohort studies that reported the MG status during or after pregnancy and relevant clinical variables. Read More

Neurology 2022 04 15;98(15):e1545-e1554. Epub 2022 Feb 15.

From the Department of Neurology (B.M.D., K.A.D., A.W.W.), Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics (B.M.D., D.T., A.W.W.), Department of Neurology, Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, School of Medicine (B.M.D., D.T., A.W.W.), and Leonard Davis Institute of Health Economics (B.M.D., A.W.W.), University of Pennsylvania, Philadelphia; and Department of Neurological Sciences (B.M.D.), University of Vermont Medical Center, Burlington.

Objective: To compare maternal obstetric complications and nonelective readmissions in women with common neurologic comorbidities (WWN) vs women without neurologic disorders.

Methods: We performed a retrospective cohort study of index characteristics and acute postpartum, nonelective rehospitalizations from the 2015-2017 National Readmissions Database using ICD-10 codes. Wald χ testing compared baseline demographic, hospital, and clinical characteristics and postpartum complications between WWN (including previous stroke, migraine, multiple sclerosis [MS], and myasthenia gravis [MG]) and controls. Read More

Cureus 2021 Dec 22;13(12):e20592. Epub 2021 Dec 22.

Pediatrics, Hospital do Espírito Santo de Évora, Évora, PRT.

Myasthenia gravis (MG) in the neonate is usually due to placentally transferred antibodies to the acetylcholine receptor (AChR), resulting in impaired neuromuscular transmission. It occurs in 10%-15% of newborns born to women with MG. We present a male newborn admitted to the neonatal intensive care unit (NICU) 38 hours after birth due to feeding difficulties and choking episodes. Read More

Cureus 2021 Dec 7;13(12):e20247. Epub 2021 Dec 7.

Department of Obstetrics and Gynecology, West Virginia University, Martinsburg, USA.

Myasthenia gravis (MG) is the most common autoimmune disorder affecting the neuromuscular junction (NMJ) of voluntary skeletal muscle. This disease is characterized by ptosis, diplopia, facial muscle weakness, bulbar muscle involvement including dysphagia and difficulty chewing, dysarthria, hypophonia, respiratory muscle fatigue, and sometimes generalized weakness. A myasthenic crisis (MC) is a complication of MG. Read More

Geburtshilfe Frauenheilkd 2021 Dec 8;81(12):1301-1306. Epub 2021 Dec 8.

Perinatalzentrum, Klinik für Gynäkologie und Geburtshilfe, Berlin, Germany.

Myasthenia gravis is an autoimmune disease with a range of clinical presentations which manifest as combinations of weakness of the ocular, bulbar, and respiratory muscle groups and muscles of the extremities. Young women of reproductive age are most commonly affected. Preconception planning, the impact of pregnancy, prepartum management, drug therapy in pregnancy, myasthenic and cholinergic crises, fetal monitoring, peripartum management including analgesia and anesthesia during labor and cesarean section as well as neonatal management and neonatal myasthenia gravis are described here and the appropriate recommendations are given. Read More

Dtsch Arztebl Int 2022 Mar;119(9):145-156

Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn; Department of Rheumatology and Hiller, Forschungszentrum University Hospital Düsseldorf; Katholisches Klinikum Bochum, Neurology Clinic,Clinic of Ruhr-Universität Bochum; Department of Medicine II, Division of Gastroenterology and Endocrinology, University Medical Center Rostock; Department of Obstetrics and Prenatal Medicine, Center for Obstetrics and Gynecology, University Hospital Bonn.

Background: Pregnancies in women with chronic disease are on the rise. This pertains to autoimmune diseases in particular since these tend to affect women of childbearing age. The interaction between pregnancy and autoimmune disease may increase the risk of maternal, fetal, and obstetric complications; additional care may be required. Read More

Medicina (Kaunas) 2021 Nov 20;57(11). Epub 2021 Nov 20.

Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Myasthenia gravis (MG) is an autoimmune condition, that commonly impacts adult women of reproductive age. Myasthenia gravis in pregnancy is rare, but the incidence is higher in different geographical areas. Pregnancies in mothers with MG can have an unfortunate outcome. Read More

J Med Case Rep 2021 Oct 10;15(1):498. Epub 2021 Oct 10.

Department of General Medicine, First Affiliated Hospital of Soochow University, Suzhou, 215031, China.

Background: Autoimmune diseases refers to a class of diseases involving abnormal immune response of human body and tissue damage caused by the dysregulation of autoimmune balance or destruction of immune tolerance. Recent research has revealed that the occurrence of autoimmune diseases is influenced by genetic, hormonal, immunological, and environmental factors. As sex hormone levels change obviously during pregnancy and postpartum, the morbidity and recurrence rate of autoimmune diseases increase during this period. Read More

J Matern Fetal Neonatal Med 2021 Sep 28:1-9. Epub 2021 Sep 28.

Orthogyn Medical Center & II SAGBAL Sheinovo, Sofia, Bulgaria.

Objectives: The aim of our study was to investigate the interrelations of symptoms, clinical outcomes and treatment regimens in pregnant women, diagnosed with myasthenia gravis and superimposed COVID-19 infection.

Methods: We conducted an observational retrospective study between August, 2020 and July, 2021. Five patients with preexisting MG and superimposed COVID- infection were included in our study. Read More

Obstet Med 2021 Jun 19;14(2):121-124. Epub 2020 Oct 19.

Department of Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

We describe a 40-year-old female who presented with progressive breathlessness and hypercapnic respiratory failure during pregnancy secondary to undiagnosed muscle-specific kinase myasthenia gravis. Her presentation was progressive and protracted, having over five contacts with healthcare professionals over nine months, many of these predating her pregnancy. Her atypical presentation for myasthenia with minimal limb weakness led to consideration of other causes of hypercapnic respiratory failure. Read More

Cureus 2021 Jun 29;13(6):e16024. Epub 2021 Jun 29.

Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, IND.

Objective Pregnancy with an autoimmune disorder is faced with several risks for mother and fetus. The aim of the present study is to analyze the course and outcome of pregnancy in women with autoimmune disorders (AIDs). Methods A retrospective cohort study was conducted at a tertiary care teaching hospital. Read More

Arq Neuropsiquiatr 2021 07;79(7):624-629

Universidade Federal do Paraná, Complexo Hospital de Clínicas, Serviço de Doenças Neuromusculares, Curitiba PR, Brazil.

Myasthenia gravis (MG) is an autoimmune disease in which the peak incidence is among women of childbearing age. For this reason, there is an overlap between the occurrence of this disease and pregnancy. It is known that MG symptoms can worsen during pregnancy and postpartum, and that pregnancy has special characteristics in MG patients. Read More

Pediatr Neonatol 2021 11 19;62(6):581-590. Epub 2021 Jun 19.

Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, Japan. Electronic address:

Between 10% and 20% of neonates born to mothers with myasthenia gravis (MG) develop neonatal MG due to the transfer of maternal autoantibodies across the placenta. Neonatal MG can occur in infants born not only from mothers with acetylcholine receptor (AChR) or muscle-specific tyrosine kinase (MuSK) antibodies but also from mothers without detectable muscle antibodies. The low incidence rate may be due to specific autoantibody characteristics that differ among individuals, but a genetic predisposition in some infants is possible. Read More

Curr Treat Options Neurol 2021 21;23(7):22. Epub 2021 Jun 21.

Department of Neurology, Washington University, St. Louis, MO USA.

Purpose Of Review: To summarize recent changes in management and emerging therapies for pregnant neurocritical care patients.

Recent Findings: Diagnostic and treatment options for managing neurologic emergencies in pregnant patients have expanded with both greater understanding of the effects of imaging modalities and medications on pregnancy and application of standard treatments for non-pregnant patients to pregnant populations. Specifically, this includes cerebrovascular diseases (pregnancy-associated ischemic stroke, pregnancy-associated intracerebral hemorrhage, cerebral venous sinus thrombosis), post-maternal cardiac arrest care, seizures and status epilepticus, myasthenia gravis, and fetal somatic support in maternal death by neurologic criteria. Read More

Case Rep Neurol 2021 Jan-Apr;13(1):65-72. Epub 2021 Feb 1.

Department of Neurology, University of South Florida, Tampa, Florida, USA.

The recombinant humanized monoclonal antibody eculizumab has been shown to be effective and well tolerated in patients with anti-acetylcholine receptor antibody-positive, treatment-refractory generalized myasthenia gravis (gMG). Myasthenia gravis (MG) often affects women of child-bearing potential. However, management can be challenging during pregnancy, and current treatment options are limited due to potential teratogenicity. Read More

Rev Neurol (Paris) 2021 Mar 26;177(3):215-219. Epub 2021 Feb 26.

Service d'électroneuromyographie et pathologies neuromusculaires - Hôpital Pierre-Wertheimer - CHU de Lyon HCL - GH Est, 59, boulevard Pinel, Bron cedex, Lyon, France. Electronic address:

Myasthenia gravis is an autoimmune disease characterised by fluctuating muscle weakness, which worsens during activity. It affects particularly scapular and pelvic girdles, axial and bulbar muscles. Myasthenia gravis is twice more frequent in women and symptoms often appear in the second and third decade of life. Read More

Zhonghua Nei Ke Za Zhi 2021 Feb;60(2):117-121

Department of Neurology, the First Medical Center of PLA General Hospital, Beijing 100853,China.

To study the clinical characteristics of pregnant patients with myasthenia gravis (MG) and the influence of MG to pregnancy. A retrospective study was conducted including 28 MG patients with 38 pregnancies admitted to the 8th Medical Center of PLA General Hospital between January 2013 and October 2018. Data were collected including clinical scores of MG, serum level of acetylcholine receptor (AChR) antibodies, abnormal repetitive nerve stimulation (RNS) and history of thymectomy before pregnancy. Read More

Can J Neurol Sci 2021 11 12;48(6):767-771. Epub 2021 Jan 12.

Department of Medicine, Division of Neurology, Ellen and Martin Prosserman Centre for Neuromuscular Diseases, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Canada.

Background: Myasthenia gravis (MG) is an autoimmune disorder that frequently affects young women of reproductive age. The multidirectional interplay between MG, pregnancy, and fetal health poses a complex scenario for pregnant women with MG and the healthcare team. Here, we reviewed our local experience with MG, pregnancy, and outcomes. Read More

J Matern Fetal Neonatal Med 2020 Nov 1:1-6. Epub 2020 Nov 1.

Department of Obstetrics and Gynecology, Maternal and Fetal Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Objective: To survey OB-GYNs regarding their practice patterns and perspectives when it comes to using magnesium sulfate (magnesium) in the prevention of eclampsia.

Study Design: We conducted a cross-sectional web-based 18-item survey given to 564 practicing OB-GYNs in the Pregnancy-Related Care Research Network. The survey used clinical scenarios to look at provider practices for preventing eclampsia in patients who have preeclampsia and relative contraindications to magnesium. Read More

Medicine (Baltimore) 2020 Oct;99(44):e22978

King Abdulaziz University, Faculty of Medicine and King Abdulaziz University Hospital, Internal medicine department, Neurology Division, Jeddah, Saudi Arabia.

This cross-sectional study aimed to assess the impact of epilepsy, myasthenia gravis (MG), and multiple sclerosis (MS) on pregnancy and family planning decision-making in a cohort of Saudi women. Women with epilepsy, MG, and MS were recruited consecutively at the time of their follow-up visits at a neurology clinic. Data were collected using 3 standardized questionnaires, and presented using descriptive statistics. Read More

Muscle Nerve 2020 12 28;62(6):664-672. Epub 2020 Sep 28.

Department of Neurology, Henry Ford Hospital, Detroit, Michigan.

Myasthenia gravis (MG) is an autoimmune disorder with bimodal age of presentation, occurring in young women of reproductive age and at an older age in men. Occasionally, MG is diagnosed during pregnancy. Management of MG includes symptomatic treatment with cholinesterase inhibitors and immunosuppressive therapy for controlling the disease activity. Read More

Ther Adv Neurol Disord 2020 25;13:1756286420949808. Epub 2020 Aug 25.

Department of Neurology, St. Josef Hospital Bochum, Ruhr University of Bochum, Gudrunstrasse 56, Bochum, 44791, Germany.

Neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis (AE), myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are antibody-mediated neurological diseases. They have mostly female predominance, affecting many women during childbearing age. Interactions between the underlying disease (or necessary treatment) and pregnancy can occur in every of these illnesses. Read More

J Allergy Clin Immunol 2020 09;146(3):467-478

Weill Cornell Medicine, New York, NY.

The humoral immune response provides specific, long-lived protection against invading pathogens, via immunoglobulin production and other memory functions. IgG, the most abundant immunoglobulin isotype, has the longest half-life and protects against bacterial and viral infections. The neonatal Fc receptor (FcRn) transports IgG across barriers, for example, the placenta, enhancing fetal humoral immunity to levels similar to their mothers'. Read More

Toxins (Basel) 2020 08 7;12(8). Epub 2020 Aug 7.

Poison Control Centre and National Toxicology Information Centre-Toxicology Unit Istituti Clinici Scientifici Maugeri IRCCS, Maugeri Hospital, Pavia Via Salvatore Maugeri, 10, 27100 Pavia, Italy.

Botulinum neurotoxins (BoNTs) produced by species are the most potent identified natural toxins. Classically, the toxic neurological syndrome is characterized by an (afebrile) acute symmetric descending flaccid paralysis. The most know typical clinical syndrome of botulism refers to the foodborne form. Read More

Handb Clin Neurol 2020 ;172:201-218

Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States. Electronic address:

Many neuromuscular disorders preexist or occur during pregnancy. In some cases, pregnancy unmasks a latent hereditary disorder. Most available information is based on case reports or series or retrospective clinical experience or patient surveys. Read More