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Plasmapheresis and IVIG treatment are used in acute myasthenia crisis to expedite recovery. Pyridostigmine, a reversible acetylcholinesterase inhibitor, improves symptoms by increasing acetylcholine concentration at neuromuscular junction and stimulating nicotinic receptors. However, this beneficial effect of pyridostigmine at neuromuscular junctions is accompanied by unwanted muscarinic activity in other organs which can lead to serious side effects.

   
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