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Muscle Nerve. 2015 Aug;52(2):216-20. doi: 10.1002/mus.24531. Epub 2015 Mar 5.

Predictive factors for myasthenic crisis after videoscopic thymectomy in patients with myasthenia gravis.

Author information

1
Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
2
Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea.
3
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

Abstract

INTRODUCTION:

Predictive factors for myasthenic crisis after transsternal thymectomy have been reported, but little is known about myasthenic crisis after videoscopic thymectomy (MCAVT).

METHODS:

We investigated 146 myasthenia gravis patients who underwent videoscopic thymectomy.

RESULTS:

Patients with MCAVT had a lower forced vital capacity (FVC) (2.1 vs. 3.0 L, P < 0.001) than those without. Low-frequency repetitive nerve stimulation showed decremental responses of the orbicularis oculi (47.1% vs. 18.1%, P = 0.001) and nasalis muscles (54.1% vs. 21.4%, P < 0.001), which were more pronounced in patients with MCAVT than those without. According to multivariate analysis, FVC (OR 0.144, 95% confidence interval [CI], 0.044-0.479, P = 0.002) and decremental response of orbicularis oculi (odds ratio, 1.029; 95% CI, 1.001-1.058, P = 0.044) were independently associated with MCAVT.

CONCLUSIONS:

FVC and decremental response of orbicularis oculi were associated with MCAVT.

KEYWORDS:

myasthenia gravis; myasthenic crisis; prognosis; thymectomy; videoscopic thymectomy

PMID:
25470186
DOI:
10.1002/mus.24531
[Indexed for MEDLINE]

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