The Medical Resistance Myasthenia Gravis and Thymectomy

Abstract

Objective: To study the clinical improvement after thymectomy in the Myasthenia gravis (MG) patients who cannot archive in remission by medical treatment alone. Patients & Method: Three years retrospective study (Budget year 2006-2008) from medical records of the MG patients in neurological clinic of Maharat Nakhon Ratchasima Hospital who had fluctuation of  weakness while use medical treatment, were thymectomized by thoracic surgeon. The data were comparing clinical signs and symptoms before and after thymectomy. Results: Twelve recruiting MG patients who failed medical treatment were conducted to thymectomy. All 12 patients were classified according to Osserman’s classification I to III. The computerized tomography of chest investigation, only one patient showed thymus gland enlargement. After thymectomy, 10 of 12 (83.3%) had positive result. Only 2 of 12 were not improved. The improvement consisted of no ptosis, increased proximal muscle strength, no respiratory problem and no dysphagia. All surgically removed thymic  tissues were hyperplasia. Conclusion: Thymectomy was the good treatment for the MG patients, who failed from medical treatment.