MRCP2-3014

MRCP2-3014

You receive a call from a GP in the community regarding a 67-year-old female patient who was diagnosed with generalised myasthenia gravis six years ago. She was last reviewed in neurology outpatients 6 weeks ago and reports no improvements in her neck weakness, voice weakness and fatigue. Her pyridostigmine dose was increased from 90 mg QDS to 120mg QDS in the neurology clinic. Although she does not appear acutely unwell, she complains that her symptoms significantly affect her life. She has no other past medical history. During examination by her GP, she shows no signs of respiratory distress and is able to swallow salivary secretions normally. What advice would you give in this situation?