Treatment for refractory myasthenia gravis 1191 Treatment for refractory myasthenia gravis

SUMMARY An 8 year old girl with ocular myasthenia gravis was treated with high dose intravenous immunoglobulin and high dose intravenous methyl-prednisolone. Ocular symptoms recurred seven months after the start of the immunoglobulin. She has been in remission for more than 12 months after two courses of intravenous methylprednisolone, and administration of oral prednisolone was discon-tinued. Recently, high dose intravenous immunoglobulin and high dose intravenous methylprednisolone have been reported to improve the symptoms of general-ised myasthenia gravis. 2 We have treated a patient with ocular myasthenia gravis refractory to several anticholinesterase compounds and oral predniso