The epidemiology of myasthenia gravis.

This review has attempted to show what the patient population with MG really looks like. Generalizations about the manifestations of the disease may not be accurate if they are derived from small numbers of patients. The epidemiologic "big picture" provides a more realistic overview of the disease. There are surprisingly fewer patients with MG than many experienced clinicians expect. This does not diminish the impact of the disease on the individual patient, but it does give a more realistic view of its place among diseases affecting the nervous system. This knowledge can be used to direct the approach to the disease in the future. The fact that the number of patients with the disease is increasing in older age groups is a tribute to the success of treatment strategies during the past 20 years. As a consequence, the typical patient with MG in the future will likely be older and have additional medical problems. The evolution of our treatment in the future will need to take this factor into consideration. Older patients may not tolerate the aggressive immunosuppressive regimens that benefit young patients. Ideally, more targeted types of therapies that suppress a specific immunologic abnormality without imposing the burden of side effects inherent in present treatments will be most beneficial to these patients.