Current opinion in neurology
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Myasthenic syndromes are distinct disorders at the neuromuscular junction, most often with well characterized autoimmune or genetic pathology. New aspects of the dysfunctions give insight into the normal neuromuscular function in addition to giving therapeutic clues and tailoring the therapy to the pathophysiology in individual patients. ⋯ Myasthenic syndromes and myasthenia gravis are well characterized disorders. The prognosis is generally good, apart from paraneoplastic Lambert-Eaton myasthenic syndrome. However, patients need long-term symptomatic and immunoactive treatment, this treatment to be balanced against present and potential side effects. New and more selective treatment is needed, especially for severe generalized disease. Well controlled long-term studies of sufficient power are much wanted, but new therapy has often to be tried in patients before high-class evidence of effect on myasthenia gravis has been published.