Assessing Treatment Decisions for Myasthenia Gravis: George Small, MD


The adult neurologist at Allegheny Health Network provided insight on the steps taken to ensure a patient with myasthenia gravis is on an effective and safe therapy. [WATCH TIME: 7 minutes]

WATCH TIME: 7 minutes

"There are many patients who are young and health who need to be treated now. They deserve to be treated now. Many of them are not particularly compliant with the bloodwork needed to make sure that we’re not hurting their kidneys or livers with these pills."

Myasthenia gravis (MG), a rare long-term condition that causes muscle weakness, can be difficult to diagnose, and is typically done with several tests. The main test is a blood test to look for a type of antibody that stops signals being sent between the nerves and muscles. If those findings are normal, doctors may suggest an electromyography of a patients’ muscles to see whether the signals are still being disrupted. CT or MRI scans can also be used to check if patients have an enlarged or abnormally growing thymus gland.

For George Small, MD, an adult neurologist at Allegheny Health Network, the steps taken to ensure an accurate diagnosis are extremely crucial to the disease management and approach of MG. Once clinicians feel they’ve made an accurate diagnosis, there are several different medications—steroids, immunosuppressants, pyridostigmine, and others—that can help control symptoms of the disease. Steroids, also known as corticosteroids, are usually taken along with acetylcholinesterase inhibitors; although, they can come with a range of adverse effects, including anxiety and irritability, weight gain due to increased appetite, and irregular heartbeat, among others.

In an interview with NeurologyLive®, Small discussed the conversations and complexities when choosing an appropriate treatment for patients with MG. He provided insight on the factors weighed during that time, the ongoing dilemma of when to use steroids, and how insurance plays a factor into the availability of certain therapies.

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