Medknow Publications on behalf of the Neurological Society of India
Vol. 52, No. 4, 2004, pp. 453-456
Bioline Code: ni04154
Full paper language: English
Document type: Research Article
Document available free of charge
Neurology India, Vol. 52, No. 4, 2004, pp. 453-456
© Copyright 2004 Neurology India.
Myasthenic crisis: A retrospective study|
Panda S, Goyal Vinay, Behari M, Singh S, Srivastava T
BACKGROUND AND OBJECTIVE:
Myasthenic crisis (MC) is one of the important and common complications in the natural history of myasthenia gravis (MG). MC can be precipitated by multiple factors including deficiency or excess of the acetylcholinesterase inhibitors (AChEI). Any episode of MC is an emergency requiring aggressive therapy. We studied the demographic, clinical and treatment-related characteristics of patients who developed MC.
MATERIALS AND METHODS:
A retrospective study was conducted in patients with MC admitted during a 31-month period from February 1999 to August 2001, at a tertiary care center in India.
Eleven patients (9.69% of the total 114 patients with MG) were admitted with 12 episodes of MC. Mean age at presentation was 39.83 ± 13.18 years with male predominance. Seven patients had undergone thymectomy previously; of which 2 had postoperative MC. Six patients had thymoma. Steroid or cholinesterase inhibitor withdrawal and infections were the commonest precipitating factors for MC. Patients required ventilatory support for median 14 days. They responded to low volume of plasma exchange (PE) (mean 854 ml / day with mean 6.5 cycles per patient).
This report highlights that the subset of Indian patients with MG who are at risk to develop MC belong to the 3rd and 4th decade, have bulbar symptoms at presentation and are associated with thymoma. Patients with MC should have judicious drug adjustments under supervision and should be treated aggressively during impending MC.
Myasthenia gravis, myasthenic crisis, thymoma
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