Myasthenia gravis response to treatment. Clinical and physiological criteria.

ABSTRACT

Twenty three patients with myasthenia gravis, eight males and 65% respectively were admitted to Al-Yarmok Teaching Hospital in Baghdad. The most commonly affected age group was between 10-30 years[78%]. A complete clinical examination with special examination with special emphasis on the peripheral and central nervous systems was done. Laboratory investigations included electromyography, CT scanning for thymomas in addition to the routine work. By classification of the patients according to the clinical criteria presented seven patients were found to have stage I myasthenia gravis, six were stage IIA and eight stage IIB, while only two patients with stage IV is recorded. Investigations revealed that six patients only had enlarged thymus gland and two patients had increased immunoglobulins. The Tensilon test was positive in almost all the patients. All patients were treated with Mestinon [Pyridostigmine bromide 100-600 mg/day] eleven of them, any how needed prednisolone in addition. The response to medical treatment was good in 16 patients and moderate in six while poor in only one patient. One patient only needed tracheostomy and other needed surgical removal of the thymus gland [thymomectomy]. These two patients were both of stage III on clinical examination