Myasthenia gravis

Perlo, Vincent P.; Poskanzer, David C.; Schwab, Robert S.; Viets, Henry R.; Osserman, Kermit E.; Genkins, Gabriel

doi:10.1212/wnl.16.5.431

Cited by 194 publications

(69 citation statements)

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“…Keynes, 1949;Simpson, 1958;Henson et al, 1965) and patients operated on in the United States (e.g. (Iigett, 1950, 1955;Perlo et al, 1966;Papatestas et al, 1]971). These publications are of little help in connection with the present problem, because none of them includes any special analysis of extrathymic neoplasms, and deaths are for the most part classified only as myasthenic or non-myasthenic.…”

Section: I)iscussionmentioning

confidence: 99%

Thymectomy and Cancer—A Follow-Up Study

Vessey¹,

Doll²

1972

Br J Cancer

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Three hundred and eighty-two patients undergoing thymectomy for myasthenia gravis at 4 London hospitals during the years 1942-64 have been followed to the end of 1967. Five of these patients died from extrathymic tumours while 5·5 would have been expected to do so from the national experience. An additional 5 patients developed non-fatal extrathymic tumours during the period of follow-up. These data provide no evidence that adult thymectomy is followed by an increased risk of neoplastic disease, but more prolonged follow-up will be required before a final conclusion can be drawn.

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Section: I)iscussionmentioning

confidence: 99%

Thymectomy and Cancer—A Follow-Up Study

Vessey¹,

Doll²

1972

Br J Cancer

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“…In the same study the bimodal age distribution was evident with the incidence in women being in the third decade in life and in the sixth or seventh decade in life for men. 2 Due to the small number of patients in our study, no specific distribution pattern of age and sex was evident.…”

Section: Discussionmentioning

confidence: 67%

“…There was no significant difference in sex in our study with males being 45.8% and females being 54.1%, however there was male predominance among OMG patients in a major study. 2 For all cases of myasthenia gravis including ocular myasthenia the incidence in female to male subjects is in the ratio of 3:2. In the same study the bimodal age distribution was evident with the incidence in women being in the third decade in life and in the sixth or seventh decade in life for men.…”

Section: Discussionmentioning

confidence: 99%

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A clinical approach to ocular myasthenia gravis

Sitaula¹,

Sharma²,

Thapa³

et al. 2015

J Chitwan Med Coll

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Myasthenia gravis is a common disorder of the neuromuscular junction characterized clinically by muscle weakness and fatigability. Ocular myasthenia is often misdiagnosed in the initial stages due to the fluctuating nature of ptosis and diplopia. Here, we describe the clinical characteristics of ocular myasthenia gravis along with the diagnostic difficulties in a tertiary eye care center in Nepal. We retrospectively reviewed the charts of the patients diagnosed as ocular myasthenia gravis in Neuro-ophthalmology clinic, BPKLCOS, from 2010 to 2013. The diagnosis of ocular myasthenia was based on the association of typical history and signs together with at least one of these features: unequivocal improvement of ocular signs after injection of neostigmine, positive response to electrophysiological tests and detection of serum antibodies to acetylcholine receptors. There were 24 cases of diagnosed ocular myasthenia gravis during the 3 years. Among them 11 cases (45.8%) were males and 13 cases (54.1%) were females. The mean age was 32.04±19.56 years with the age range from 9 years to68 years. The most common symptoms among patients were drooping of the lids (45.8%, n=11), followed by both double vision and drooping of the lids (37.5%, n=9) and only intermittent double vision in16.6% (n=4). In two patients (9.09%) CT-scan findings were suggestive of thymoma. The symptoms were resolved with anticholinesterases alone in 66.6% (n=16) and anticholinesterases were supplemented with immunosuppressive drugs in 33.3% (n=8) patients. Ocular myasthenia is often misdiagnosed in the initial stages due to its fluctuating nature. With a high index of clinical suspicion simple clinical tests accompanied by pharmacological tests can be useful in diagnosing the condition.DOI: http://dx.doi.org/10.3126/jcmc.v4i3.11931Journal of Chitwan Medical College 2014; 4(3): 5-8

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“…Untreated weakness becomes permanent after 15 to 20 years, and atrophy can occur in the most affected muscles. Modified Osserman classification is used to determine the clinical status of the patients (Table 1) [6].…”

Section: Mg Diagnosismentioning

confidence: 99%

Thymectomy in Myasthenia Gravis

Aydın¹,

Ulaş²,

Mutlu³

et al. 2017

Eurasian J Med

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In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis (MG). Likelihood of remission was highest in preoperative mild disease classification (Osserman classification 1, 2A). In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy. In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: transcervical, minimally invasive, transsternal, and combined transcervical transsternal thymectomy. Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques. However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches.Keywords: Extended thymectomy, follow-up, myasthenia gravis, thoracoscopic thymectomy ÖZ Miyastenia gravis tedavisinde son yıllarda timektomi giderek yaygınlaşan bir prosedür haline geldi. Preoperatif hafif hastalık sınıflaması (Osserman sınıflaması 1, 2A) olanlarda remisyon ihtimali en yüksek olarak gösterildi. Timoma veya hiperplazi yokluğunda timektomi ile remisyon sağlamada yaş ve cinsiyetin ilişkisi gösterilemedi. Miyastenia gravis tedavisinde timektomi ile konservatif tedaviyi karşılatıran randomize çalışmalar yeni yayınlanmaya başlandı. Nonrandomize çalışmalarda olduğu gibi Miyastenia gravis tedavisinde timektomi ile remisyon, sadece ilaçla konservatif tedaviden daha iyi bulundu. Cerrahi yaklaşım için transservikal, minimal invaziv, transsternal ve kombine transservikal transsternal timektomi olmak üzere dört major yöntem bulunmaktadır. Transsternal yaklaşımla timektomi yıllardır kabul gören standart cerrahi yaklaşımdır. Son yıllarda torakoskopik ve robotik yöntemin kullanıldığı minimal invaziv tekniklerle timektomi sıklığı artmaktadır. Cerrahi teknikleri karşılaştıran randomize, kontrollü çalışmalar bulunmamaktadır. Ancak nonrandimize çalışmalar arasındaki karşılaştırmalara bakıldığında minimal invaziv timektomi yaklaşımlarının daha agresif yaklaşımlara benzer sonuçlar verdiği görülmektedir.

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Myasthenia gravis

Cited by 194 publications

References 0 publications

Thymectomy and Cancer—A Follow-Up Study

Thymectomy and Cancer—A Follow-Up Study

A clinical approach to ocular myasthenia gravis

Thymectomy in Myasthenia Gravis

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