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Title of Journal: J Neurol

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Abbravation: Journal of Neurology

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Springer Berlin Heidelberg

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DOI

10.1007/bf02632863

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1432-1459

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Thymectomy role in the treatment of myasthenia gr

Authors: J Spillane M Hayward N P Hirsch C Taylor D M Kullmann R S Howard
Publish Date: 2013/03/19
Volume: 260, Issue: 7, Pages: 1798-1801
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Abstract

Thymectomy is a frequently used treatment for myasthenia gravis MG and is virtually always indicated in MG patients who have a thymoma However the evidence for thymectomy in nonthymomatous MG remains less certain—no randomised controlled trials have been published to date although one is currently underway We reviewed the management and clinical outcome of patients with MG who underwent thymectomy over a 12 year period Eightynine patients who underwent transsternal thymectomy were identified A thymoma was identified on histology in 24  whereas 48 9 and 19  had hyperplastic atrophic and normal thymic histology respectively One patient developed post operative myasthenic crisis but generally the procedure was well tolerated Outcome was favourable for the majority of patients with 34  achieving complete stable remission CSR and an additional 33  achieving pharmacological remission Moreover steroid requirements fell progressively during followup Patients with a hyperplastic gland had a significantly greater chance of achieving CSR compared to other histological subtypes and the incidence of CSR increased with a longer duration of followup Thymectomy for MG is generally safe and well tolerated and is associated with a sustained improvement of symptoms in the majority of patients

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