Which novel immunomodulatory treatment(s) do you consider in refractory seronegative bulbar-predominant myasthenia?

Topics: Neurology • Neuromuscular

Presuming failure/intolerance of steroids, MMF, azathioprine, maintenance IVIg

Answer from: at Academic Institution

Re-evaluate the diagnosis. Acetylcholine receptor and MuSK antibody-negative myasthenia with prominent bulbar symptoms, refractory to all the agents mentioned (steroids, MMF, AZA, IVIG) is an extremely rare scenario. Differential diagnosis includes bulbar onset ALS and numerous myopathies (e.g. IB...

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at UPMC
Thank you very much. This topic is always very dif...

at VCU Health
I totally agree with the thoughtful comments. I ha...

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