Premium
ASPECTS OF THE NATURAL HISTORY OF MYASTHENIA GRAVIS: CRISIS AND DEATH
Author(s) -
Cohen Michael S.,
Younger David
Publication year - 1981
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1981.tb33765.x
Subject(s) - myasthenia gravis , medicine , thymectomy , dysphagia , pneumonia , incidence (geometry) , case fatality rate , aspiration pneumonia , mortality rate , natural history , surgery , pediatrics , anesthesia , epidemiology , physics , optics
In an analysis of myasthenia crises during the past 20 years, the incidence of crisis remained fairly constant at 12-16%, but the fatality rate of crises declined from 42% to 6%, and the overall mortality of myasthenia declined from 12% to 3.3%. Most crisis episodes were caused by aspiration pneumonia or occurred in patients with severe dysphagia, who were at risk of aspiration. Cholinergic drug therapy clearly was not useful during crisis, and should probably be discontinued while the patient is on a respirator. Fifteen of 28 patients with thymectomy had 21 episodes of crisis months or years after surgery. Ultimately, 42% of crisis survivors achieved a state of improved myasthenia or remission after one or more crises.