Therapeutic Itinerary of the Patients Followed for Myasthenia Gravis in Dakar

Myasthenia gravis is an autoimmune disease caused by specific autoantibodies that induce dysfunction of neuromuscular transmission. The diagnostic procedure is similar regardless of the age of the subject. As in any disease, the management starts with the diagnosis, which is often unduly delayed. The purpose of our study was to evaluate the reasons for this delay. Methodology: This was a retrospective, transversal, and descriptive study on the files of myasthenic subjects followed over a period of four years (2014 to 2017) at the neuroscience clinic of the Univresity National Center of Fann and at the consultation of neurology of the Pikine National Hospital Center where a hetero-administered questionnaire was completed. Results: The study involved 18 myasthenic patients including 13 women and 5 men with a sex ratio of 2.6. The median age of the patients was 32 years [14 - 60 years]. The average time to patient diagnosis was 24 months. The patients had consulted on average four times before the diagnosis of myasthenia gravis. The referral hospital was the facility attended by 78% of patients and the ophthalmology service was the first service consulted by 13 patients, or 72%. The median age at onset of symptoms was 28 years. Ptosis was the first symptom in 56% of the cases. Conclusion: Myasthenia gravis is a disorder little known to the public and to practitioners. The ophthalmologist was the first remedy. It would be wise for any practitioner to know the main manifestations.