Clinical characters of the progression from childhood ocular to generalized myasthenia gravis / 中华神经科杂志

ABSTRACT

Objective To investigate the rate and the time of generalization from childhood ocular myasthenia gravis (OMG),and the preventive effect of prednisone on the progression of OMG to generalized myasthenia of gravis (GMG).Methods Retrospective study of medical data from 978 childhood patients with OMG and 1359 adult patients with OMG during a follow-up period of 1--28 years (mean 7.5 years) who were diagnosed and treated in Affiliated Hospital of Qingdao Medical College from 1977 to 2005.Results The generalized rate of childhood OMG and adult OMG was 13.0% (127/978) and 67.2% (913/1359) respectively (χ2=674.17,P < 0.01).Of 127 childhood OMG patients who had become generalized form,74 patients (58.3%) developed generalized form in the first 2 years from the onset; Of 913 adult OMG patients who had become generalized form,763 patients (83.6%) did (χ2=45.39,P < 0.01) .Of 456 childhood OMG patients treated with prednisone,only 5 patients (1.1%) became generalized form; 0f522 childhood OMG patients never treated with prednisone,122 patients (23.4%) developed the generalized form (χ2=104.9,P < 0.01).Conclusions The rate of generalization of childhood OMG is significantly decreased than that of adult OMG.The frequency of generalization of childhood OMG in the first 2 years from the onset is significantly lowered than adult OMG.Prednisone does reduce the chance of generalization from childhood OMG.