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KMID : 0390119920320020203
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Journal of Pusan Medical College
1992 Volume.32 No. 2 p.203 ~ p.210
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Myasthenia Gravis in Clinical Aspects
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Abstract
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Authors studied the clinical aspects of myasthenia gravis on 43 patients who were admitted in the Department of Neurology, Pusan National University Hospital from March, 1988, to March, 1992.
The results were as follows :
1. There were 40 female and 7 male patients with their age from 5 to 65.
2. Ocular symptoms(80.9%) including ptosis(29 cases) and diplopia( cases) were the most common initial symptom. There were also generalized weakness, dysarthria, dysphasia in order.
3. Repetitive nerve stimulation test showed significant decremental response in 31(79.5%) from 39 patients. In type I myasthenia gravis, only 44.4% of patients showed significant decremental response but in type II a and II b patients, 81.8% and
93.8%
respectively.
4. Tensilon test showed positive response in 97.9% of the patients.
5. Chest CT scans revealed normal thymic shadow in 31.5% of patients, abnormal findings including hyperplasi and anterior mediastinal mass in 68.4%, In type I myasthenia gravis, 66.7% of patients showed normal finding but in severe type(type II,
III,
IV), only 15.4% of patients did so.
6. In 26 patients with their age below 40, chest CT scans showed normal finding in 8(30.8%), thymic hyperplasia in 12, anterior mediastinal mass in 5 cases. Chest CT scans on 12 patients above 40 of their age showed normal finding in 3(25%),
thymic
hyperplasia in 5, anterior mediastinal mass in 4 cases.
7. Histologic findings of 22 cases revealed normal in 2, thymic hyperplasia in 15, benign thymoma in 2, invasive thymoma in 3 cases.
8. 14.9% of patients has associated tyroid adnormalities such as hyperthyroidism, simple goiter, thyroid Huthle cell carcinoma, and thyroiditis.
9. Anti-acetylcholine receptor antibody assay revealed significantly increased titer(2-906nmol/l) in 8 of 12 saces studied and there was no correlation between anti-acetylcholine receptor antibody titer and the severity of myasthenia gravis.
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