What is your approach to managing seronegative myasthenia gravis in patients who have not responded to immunotherapy?

The quick and easy answer is that the diagnosis must be reconsidered. To facilitate the discussion, I would divide the seronegative patients into two groups: ocular and generalized.

I assume that patients have been tested for AchR, MuSK antibodies (and possibly LRP4?), and the results are negative....