ACHE and myasthenia gravis: Although acetylcholinesterase inhibitors (AChEIs) have been traditionally used as first-line therapy for MG, a recent clinical investigation revealed that only 4.2% of MuSK-MG patients achieved initial clinical improvement with AChEI, while a substantial proportion (76.9%) experienced adverse effects, predominantly including neuromuscular hyperexcitability, gastrointestinal disturbances, and neurovegetative dysfunction (11).