Novel Challenges in Myasthenia Gravis

Tommaso Claudio Mineo, MD (Editor)
Professor and Head Dept. of Thoracic Surgery, Policlinico Tor Vergata University, Rome, Italy

Series: Muscular System – Anatomy, Functions and Injuries
BISAC: MED079000

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Volume 10

Issue 1

Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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Myasthenia gravis is a complex subject, multidisciplinary and challenging in terms of its clinical, therapeutic and evolutionary aspects. This is evident in the gradual changes over time and in the variety of clinical presentations, the mutable therapeutic responses and the difficulties to standardize the evaluation of results. It is remarkable to review the many advances made in the field of myasthenia gravis.

This book is proof of considerable progress made and of the fact that new knowledge today is acquired in shorter time than in the past. This acceleration is a signal of many successful technological advances in clinical and laboratory research. Even in myasthenia gravis, as in other research areas, researchers expect more from new achievements in rapid growing disciplines such as with immunology and genetics. To this, the authors’ wanted to draw the attention of the readers.
(Imprint: Nova Biomedical)

Preface

Acknowledgements

Contributors

Part 1: General Aspects

Chapter 1
Myasthenia Gravis: A Historical Perspective
(Federico Tacconi, Tommaso Claudio Mineo, Department of Thoracic Surgery, Multidisciplinary Myasthenia Gravis Unit, Tor Vergata University, Rome, Italy)

Chapter 2
Actual World Epidemiology of Myasthenia Gravis
(Aisling Carr, Department of Neurology, Belfast Health and Social Care Trust, Belfast, Northern Ireland)

Chapter 3
Natural History of Myasthenia Gravis
(Lukas Kirzinger, Berthold Schalke, Division of Neurology, Regensburg University, Regensburg, Germany)

Chapter 4
The Neuromuscular Junction and Myasthenia Gravis
(Rawan Tarawneh, Vern C. Juel, Department of Neurology, Duke Medical Center, Durham, USA)

Chapter 5
Quality of Life and Social Impact of Myasthenia Gravis
(Kelly G. Gwathmey, Kimiaki Utsugisawa, Ted Burns, Department of Neurology, University of Virginia, Charlottesville, USA)

Part 2: Current Events

Chapter 6
New Concepts in Immunopathogenesis of Myasthenia Gravis
(Nadine Dragin, Sonia Berrih-Aknin, Institute of Myology, University Pierre and Marie Curie, Paris, France)

Chapter 7
Advanced Genetics in Myasthenia Gravis
(Konstantinos Poulas, Zoi Zagoriti, Manousos Kambouris, George Lagoumintzis, Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, Patras, Greece)

Chapter 8
Autoimmune Diseases Associated with Myasthenia Gravis
(Raffaele Iorio, Institute of Neurology, Catholic University, Rome, Italy)

Chapter 9
Histological Pictures of the Myasthenic Thymus
(Philippe Stroebel, Alexander Marx, Institute of Pathology, University Medical Center Göttingen, Germany, and others)

Part 3: New Clinic Orientations

Chapter 10
Clinical Presentation, Diagnosis and Classification
(Amelia Evoli, Institute of Neurology, Catholic University, Rome, Italy)

Chapter 11
Congenital Myasthenic Syndrome: Natural History and Treatment
(Sujit Jagtap, Department of Neurology, Sree Chitra Institute for Medical Science and Technology, Trivandrum, India)

Chapter 12
Juvenile Myasthenia Gravis: From Diagnosis to Treatment
(Diana Castro, Pediatric Neurology, University of Texas Southwestern, Children Medical Center, Dallas, USA)

Chapter 13
Pure Ocular Myasthenia: What’s New
(Berthold Schalke, Lukas Kirzinger, Division of Neurology, Regensburg University, Regensburg, Germany)

Chapter 14
Myasthenic Crisis: Diagnostic and Therapeutic Approach
(Syed Omar Kazmi, Jose I Suarez, Division of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, USA)

Chapter 15
Refractory Myasthenia Gravis
(Joome Suh, Richard Nowak, Department of Neurology, Yale University, New Haven, USA)

Chapter 16
Management of Concomitant Diseases in the Myasthenic Patient
(Roberto Massa, Vincenzo Ambrogi, Tommaso Claudio Mineo, Department of Neurology, Tor Vergata University, Rome, Italy, and others)

Chapter 17
Current Approach to Myasthenia Gravis in Pregnancy
(Fiona Norwood, David Hilton-Jones, Department of Neurology, King’s College Hospital, London, UK, and others)

Chapter 18
Frontiers of Oral Health Care in Myasthenic Patients
(Pavan M. Patil, Department of Oral and Maxillofacial Surgery, Sharda University, Greater Noida, Uttar Pradesh, India)

Chapter 19
Role of Physiotherapy in Myasthenic Patients
(Vincenzo Ambrogi, Tommaso Claudio Mineo, Department of Thoracic Surgery, Multidisciplinary Myasthenia Gravis Unit, Tor Vergata University, Rome, Italy)

Part 4: Surgery

Chapter 20
Innovations in Anesthesia for Thymectomy in Myasthenic Patients
(Julien Pottecher, Olivier Helms, Anesthesiology and Critical Care Medicine, Hôpitaux Universitaires de Strasbourg, Strasbourg, France)

Chapter 21
Transternal Thymectomy: From Simple to Extended and Maximal
(Maria Elena Cufari, Michael Dusmet, Division of Thoracic Surgery,Tor Vergata University, Rome, Italy, and others)

Chapter 22
Transcervical Thymectomy: Past and Future
(Joseph B. Shrager, Division Thoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA)

Chapter 23
Right VATS Thymectomy: Conventional and Single Port Approaches
(Calvin SH Ng, Anthony PC Yim, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China)

Chapter 24
Left VATS Thymectomy
(Tommaso Claudio Mineo, Vincenzo Ambrogi, Department of Thoracic Surgery, Multidisciplinary Myasthenia Gravis Unit, Tor Vergata University, Rome, Italy)

Chapter 25
Robotic Approach to Thymectomy for Non-Thymomatous Myasthenia Gravis
(Nicola Santelmo, Stephane Renaud, Thoracic Surgery Department, Nouvel Hôpital Civil, Strasbourg University, Strasbourg, France)

Chapter 26
Robotic Thymectomy in Children with Myasthenia Gravis
(Shannon Rosati, Joseph Hartwich, Rami Maarouf, Dan Parrish, Claudio Oiticica, Jean Teasley, David Lanning, Department of Surgery, Division of Pediatric Surgery, Children’s Hospital of Richmond, Virginia Commonwealth University, Richmond, Virginia, USA, and others)

Chapter 27
Alternative Approaches to Nonthymomatous Thymectomy for Myasthenia Gravis through the Subxiphoid Incision
(Marcin Zielinski, Department of Thoracic Surgery of Pulmonary Hospital, Zakopane, Poland)

Chapter 28
Surgery of Thymomatous Myasthenia Gravis
(Cameron D. Wright, Division of Thoracic Surgery, Massachusetts General Hospital, Boston, USA)

Chapter 29
Surgical Treatment of Blepharoptosis in Myasthenic Patients
(Yusuke Shimizu, Shigeaki Suzuki, Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Japan)

Part 5: New Horizons

Chapter 30
Present and Future Non-Surgical Treatment
(Anne T. Heldal, Nils E. Gilhus, Department of Clinical Medicine, University of Bergen, Bergen, Norway)

Chapter 31
Novel Therapeutic Frontiers for New Improvements of Myasthenia Gravis
(Jonathan M. Beary, Yuebing Li, Neuromuscular Center, Neurological Institute, Cleveland Clinic, Cleveland, USA)

Chapter 32
New Biological Role of Thymectomy for Myasthenia Gravis
(Meinoshin Okumura, Hiroyuki Shiono, Masayoshi Inoue, Yasushi Shintani, Department of General Thoracic Surgery, Osaka University, Osaka, Japan, and others)

Chapter 33
Clinical Trials of Myasthenia Gravis
(Jumana Alshaikh, Linda L. Kusner, Henry J. Kaminski, Department of Neurology, George Washington University, Washington, USA, and others)

Epilogue

Index

Audience: Medical students, residents, post-doctoral fellows, as well as senior physicians/researchers in every area related to myasthenia gravis: surgeons, neurologists, anesthesiologists, immunologists, physiotherapists, and many others.

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