A LOOK INTO MYASTHENIA GRAVIS Edited by Joseph A. Pruitt A Look into Myasthenia Gravis Edited by Joseph A. Pruitt Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Oliver Kurelic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published January, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] A Look into Myasthenia Gravis, Edited by Joseph A. Pruitt p. cm. ISBN 978-953-307-821-2 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface VII Part 1 Clinical Presentations 1 Chapter 1 Myasthenia Gravis with Anti-MuSK Antibodies: Clinical Features and Histopathological Changes 3 Corrado Angelini, Sara Martignago, Michela Biscigli and Elisa Albertini Chapter 2 Ocular Manifestations of Myasthenia Gravis 15 Joseph A. Pruitt and Pauline Ilsen Part 2 Treatments 21 Chapter 3 Myasthenia Gravis – Current Treatment Standards and Emerging Drugs 23 Kamil Musilek, Marketa Komloova, Ondrej Holas, Anna Horova, Jana Zdarova-Karasova and Kamil Kuca Chapter 4 Immunomodulatory Treatments for Myasthenia Gravis: Plasma Exchange, Intravenous Immunoglobulins and Semiselective Immunoadsorption 43 Fulvio Baggi and Carlo Antozzi Chapter 5 Respiratory Care for Myasthenic Crisis 55 Ping-Hung Kuo and Pi-Chuan Fan Part 3 Surgical Considerations 75 Chapter 6 Unilaterally Extended Thoracoscopic Thymectomy: The Right Side or the Left Side Approach 77 Victor Tomulescu Chapter 7 Robotic Thymectomy 95 Victor Tomulescu Preface This publication is the result of the joining of forces, so to speak, of a diverse group of professionals in an effort to depict the many manifestations of myasthenia gravis. Although, in the grand scheme of things, only a few manifestations are covered in this text, the far-reaching effect of this disease is not lost. From the surgical treatment of the disease's complications to the common findings of a routine eye examination, this text explores this disease's impact in a variety of outlets within healthcare. We hope you find this text interesting, but most importantly informative. Enjoy. Joseph A. Pruitt Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota, University of Missouri-Saint Louis College of Optometry, Saint Louis, Missouri USA Part 1 Clinical Presentations