Systematic Review: Comprehensive Nursing Management of
Myasthenia Gravis in Adults
Chikku S.
M.Sc. (N), Ph.D Scholar, Associate Professor, Medical Surgical Nursing
Department,
Holycross College of Nursing, Kottiyam.
*Corresponding Author Email: daschikku826@gmail.com
ABSTRACT:
Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disorder characterized by fluctuating skeletal muscle weakness and fatigability. Due to its variable presentation and episodic course, MG poses significant challenges in diagnosis, treatment adherence, and long-term care. Nurses play a vital role in early recognition, monitoring disease progression, preventing complications, and providing patient-centered education. This systematic review aims to synthesize available evidence on nursing considerations in the management of adults with Myasthenia Gravis, with emphasis on clinical care, prevention of complications, psychosocial support, and multidisciplinary coordination. A systematic literature search was conducted using PubMed, Google Scholar, National Institutes of Health (NIH), and World Health Organization (WHO) databases. Articles published in English between 2000 and 2025 were reviewed. Keywords included “Myasthenia Gravis,” “adult nursing care,” “autoimmune neuromuscular disorders,” and “nursing management.” Peer-reviewed articles, clinical studies, guidelines, and authoritative reports were analyzed. Myasthenia Gravis is primarily mediated by antibodies against acetylcholine receptors or related neuromuscular junction proteins, resulting in impaired neuromuscular transmission. Major nursing concerns include respiratory monitoring, medication management, prevention of myasthenic crisis, fatigue management, nutritional support, and psychological care. Patient education and multidisciplinary collaboration were essential in improving treatment adherence and quality of life. Nursing care is fundamental to the comprehensive management of adults with Myasthenia Gravis. Early identification, vigilant assessment, individualized interventions, and continuous education significantly enhance patient safety, functional independence, and overall quality of life.
KEYWORDS: Myasthenia Gravis, Autoimmune Neuromuscular Disorders, Adult Nursing Care, Nursing Management, Muscle Weakness, Quality of Life.
INTRODUCTION:
Myasthenia Gravis (MG) is a rare, chronic autoimmune neuromuscular disorder characterized by fluctuating weakness of voluntary muscles that worsens with activity and improves with rest.1 The condition commonly affects adults between 20–50 years, with a female predominance in younger adults and male predominance in later life.2 MG significantly impacts physical functioning, daily activities, and psychological well-being, thereby requiring comprehensive and long-term nursing care. Delayed diagnosis and improper management can lead to life-threatening complications such as myasthenic crisis.3
A systematic literature review was conducted to identify evidence related to nursing considerations in adult patients with Myasthenia Gravis. Electronic databases including PubMed, Google Scholar, National Institutes of Health (NIH), and World Health Organization (WHO) were searched. Keywords included “Myasthenia Gravis,” “adult nursing care,” “autoimmune neuromuscular disorders,” and “nursing management.” Articles published in English between 2000 and 2025 were included. Review articles, clinical studies, practice guidelines, and authoritative reports were screened and synthesized.4
Myasthenia Gravis has an estimated prevalence of 15–20 per 100,000 population worldwide.1 The disease is caused by autoantibodies directed against acetylcholine receptors (AChR), muscle-specific kinase (MuSK), or other components of the neuromuscular junction.5 These antibodies impair neuromuscular transmission, leading to reduced muscle contraction and fatigability. MG is often associated with thymic abnormalities and other autoimmune disorders such as thyroid disease and rheumatoid arthritis.6
Clinical manifestations include fluctuating muscle weakness affecting ocular, bulbar, respiratory, and limb muscles. Ptosis and diplopia are common early signs.2 Bulbar symptoms such as dysphagia, dysarthria, and chewing fatigue increase the risk of aspiration. Generalized weakness, impaired mobility, and respiratory muscle involvement may progress to myasthenic crisis, a medical emergency. Anxiety, depression, and reduced social participation are frequently reported among adults with MG.7
Diagnosis of MG is based on clinical presentation, detection of specific autoantibodies, electrophysiological studies, and imaging of the thymus.5 Medical management includes anticholinesterase medications such as pyridostigmine, immunosuppressive therapies, corticosteroids, intravenous immunoglobulin (IVIG), and plasmapheresis in severe cases.8 Thymectomy is recommended in selected patients to improve long-term outcomes.
Nursing management of adults with MG is comprehensive and multidisciplinary. Priority areas include respiratory assessment, early detection of fatigue and muscle weakness, and prevention of myasthenic crisis. Nurses play a critical role in medication administration and monitoring for adverse effects such as cholinergic crisis. Energy conservation strategies, nutritional support, and swallowing precautions are essential nursing interventions. Psychological support, patient education regarding symptom monitoring, medication adherence, and lifestyle modification enhance self-management and safety.9 Collaboration with neurologists, respiratory therapists, dietitians, and physiotherapists ensures continuity of care.
Patients with MG are at risk of complications including myasthenic crisis, aspiration pneumonia, respiratory failure, medication-related adverse effects, and decreased quality of life. Chronic fatigue, functional dependence, and emotional distress may lead to depression and social isolation. Early nursing intervention and continuous monitoring are crucial in preventing morbidity and mortality.10
Myasthenia Gravis is a chronic autoimmune neuromuscular disorder requiring long-term, individualized management. Nurses play a pivotal role in early recognition, prevention of complications, patient education, and psychosocial support. Evidence-based nursing care and effective multidisciplinary collaboration significantly improve functional outcomes and quality of life in adults living with Myasthenia Gravis.
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Received on 29.01.2026 Revised on 02.03.2026 Accepted on 31.03.2026 Published on 30.04.2026 Available online from May 02, 2026 Asian J. Nursing Education and Research. 2026;16(2):140-142. DOI: 10.52711/2349-2996.2026.00029 ©A and V Publications All right reserved
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