Reply to letter to the editor: Difficulties classifying myasthenia gravis in the pediatric surgical literature

We received Dr. Goldstein's Letter to the Editor and greatly appreciate his comments. As he highlights, the Myasthenia Gravis Foundation of America (MGFA) scoring system is an alternative means to quantitate disease severity. Importantly, he acknowledges that this scoring system has not been validated in children but does suggest work from his group has focused on providing some modifications to adult guidelines. We certainly agree that having a standard scoring system that all practitioners utilize would be optimal.