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How do you manage myasthenia gravis in patients over the age of 90?

What is the best way to treat late onset myasthenia gravis (in this case, age >90)? Would the newer complement inhibitors be safe? Steroids in this population may be detrimental.
2 Answers
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Neurology · McMaster University
Answered on

Steroids always carry the risk for side-effects and these need to be explained to each patient and weighed against co-morbidities to determine if they are in fact reasonably indicated in a particular instance. Nevertheless, steroids should be first-line agents for elderly MG patients as a significan...

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Mednet Member
Mednet MemberInvited Expert
Neurology · VCU Health
Answered on

I agree with Dr. @Dr. First Last. When managing very late onset MG, I typically start with pyridostigmine followed by steroid ( prefer low starting dosage and titrate up based on response and tolerance, then taper once patient shows improvement). If patient failed steroid plus pyridostigmine, I typi...

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