An analysis is performed on the case of a patient in a tertiary clinic, who had a myasthenia crisis refractory to conventional therapy. This subsequently required acute treatment with plasmapheresis therapy. However, due to the persistence of the symptoms, the patient needed a complementary management with intravenous immunoglobulin therapy, presenting with a clinical improvement. Along with this case analysis, a review of the literature was performed, in order to assess the different therapies available for the treatment of a myasthenia crisis. The available evidence was also reviewed as regards the comparison of their results, as well as the therapies available and the effectiveness of applying them. In conclusion, neither of the two therapies, plasmapheresis and application of intravenous immunoglobulin, proved to be superior to the other. Therefore, the choice of either of them should be based on the patient status, the institutional availability, the risk factors, and the cost benefit analysis. © 2018 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo