ALGORITHM FOR THE DIAGNOSIS AND MANAGEMENT OF PEDIATRIC MYASTHENIA GRAVIS

Myasthenia gravis in children is a rare autoimmune disorder of neuromuscular transmission characterized by pathological muscle fatigability and variable weakness of skeletal muscles. Despite its relative rarity in pediatric practice, this condition has significant clinical importance due to the risk of generalization, development of bulbar disorders, and myasthenic crises. Clinical manifestations in children are diverse and are often limited to oculomotor disturbances, which complicates early diagnosis. In addition, the pediatric population is characterized by a high frequency of seronegative forms, which reduces the diagnostic value of standard immunological markers and requires a comprehensive approach to diagnostic verification. The article presents current data on the clinical and pathogenetic features of myasthenia gravis in children, as well as the results of analysis of our own clinical observations. The main clinical forms of the disease, diagnostic criteria, the capabilities of electrophysiological and immunological methods, and principles of medical and surgical treatment are discussed. Special attention is given to early detection and optimization of therapeutic strategies depending on the form and severity of myasthenia gravis. The obtained data indicate the predominance of oculomotor forms of myasthenia in children, the high effectiveness of anticholinesterase therapy, and the importance of timely administration of immunosuppressive agents in generalized forms of the disease. Early diagnosis and an individualized treatment approach improve prognosis and quality of life in pediatric patients.