Therapeutical aspects of disorders of the neuromuscular transmission are based on differential diagnosis between pre- or post-synaptically localized abnormalities of the neuromuscular junction, recognition of acquired and congenital forms and search for associated diseases and tumors, on prescription of drugs improving the transmission of acetylcholine and immunosuppressive agents, and on regular and quantified follow-up. In this clinical and therapeutic review, the two most common forms, myasthenia gravis and the Lambert-Eaton myasthenic syndrome, are discussed in the light of the 44 patients recently seen in our department.