Myasthenia gravis: study of 153 patients

THESES

MYASTHENIA GRAVIS: STUDY OF 153 PATIENTS (ABSTRACT)^*. DISSERTATION. CURITIBA, 1997.

FRANCISCO MARCOS BEZERRA DA CUNHA^**

Myasthenia gravis is a disease of the neuromuscular junction with remarkable symptoms of weakness and easy fatigability of ocular muscles, isolated or associated with skeletal muscles in a generalized form; this may increase with physical effort and it improves with rest and anticholinesterase drugs. Myasthenia gravis has three clinical forms: neonatal, congenital and acquired. The diagnosis of myasthenia gravis is based upon the clinical picture, pharmacological tests, electrophysiological studies and dosage of antibodies against receptors of acetylcholine (AAChR).

Our study aimed at analyzing 153 myasthenic patients as to the specific and general clinical aspects of the disease in order to identify the best methods of complementary investigation usually used, and to compare with the different conservative and surgical therapeutical procedures in correlation with the evolution of the patients.

We have analyzed, retrospectively, 153 files of myasthenic patients diagnosed from the clinical, pharmacological and electrophysiological point of view and followed up in the Service of Neuromuscular Disease of the Discipline of Neurology of the Universidade Federal do Paraná in the period of February 1973 to March 1995.

In the sample, myasthenia gravis was predominant in women (68.0%), and had a mean age of 29.5 years. The autoimmune form was the most frequent, with generalized impairment already present in the first consultation. However, the involvement of ocular muscles with ptosis and diplopia were the most frequent signs and symptoms.

The sphigomanometry and pharmacological tests were useful in the diagnosis of generalized forms of the disease. However, the test of repetitive stimulation confirmed the diagnosis in the majority of the cases.

The use of prostigmine, prednisone, other immusuppressants and plasmapheresis has had clinical efficacy, mainly in patients under 50 years old. There was no significant statistical difference between patients submitted to surgical and conservative treatment as to remission and improvement. In the thymectomized group, there was a higher frequency in the compensated control types, suggesting a greater stability of the disease with this procedure. However, our findings suggest that the different therapies have a positive influence on the clinical evolution of the disease, that follows its autolimeted course, independent on the kind of therapy.

KEY WORDS: myasthenia gravis, treatment, thymectomy.

**Address: Rua Carlos Vasconcelos, 1259 / 602, 60115-170 Fortaleza CE, Brasil.

*

Miastenia grave: estudo de 153 casos. (Resumo). Dissertação de Mestrado, Universidade Federal do Paraná. (Área: Neurologia). Orientador: Lineu César Werneck; co-orientadora: Rosana Hermínia Scola.

Publication Dates

• Publication in this collection
  06 Dec 2000
• Date of issue
  Sept 1998