Ultra-structure of the Myoneural Junction in Myasthenia Gravis

Abstract

IN myasthenia gravis the leading abnormality appears to be a disorder of transmission of the nerve impulse from the terminal expansions of the neural component of the end-plate across the myoneural junction to the muscle. The transmission of impulses is promptly restored by administration of anticholinesterasic drugs suggesting that the essential structural abnormality, if such there be, is a fine one. For this reason one must feel a reluctance to accord a primary role in the disorder of neuromuscular transmission to the florid and apparently permanent changes in the end-plates demonstrated by vital staining in myasthenic patients by Coërs and Woolf¹, Woolf et al. ² and Bickerstaff and Woolf³.