Usually neonatal myasthenia gravis is a transient disorder. In some patients the myopathic features may persist for some time.
Clinical features:
(1) The patient is born to a mother with myasthenia gravis or antibodies to acetylcholine receptor.
(2) The patient has neonatal myasthenia gravis.
(3) Myopathic features persist beyond the first 4 months after birth.
Myopathic features:
(1) dysarthria
(2) velopharyngeal incompetence with feeding or respiratory problems
Affected infants may also show:
(1) hearing impairment
(2) pyloric stenosis
(3) mild learning impairment
The hypothesis is that exposure to maternal antibodies in early fetal development results in loss of acetylcholine receptors.
If a mother has an affected infant then all future pregnancies are likely to be affected as well. Plasmapheresis during pregnancy can reduce the titer of antibody in maternal and fetal serum.
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