Intensive Care Management of Myasthenia Gravis After Thymectomy

Abstract

Aim:To evaluate the management of post thymectomy myasthenia gravis (MG) patient in our centre; to highlight those aspects of patient care that could improve outcome and to serve as a bench mark for developing a standardized protocol for management.
Method: A retrospective study of 5 cases of post thymectomy MG patients managed in the intensive care unit [ICU] of University of Nigeria Teaching Hospital, Enugu, Nigeria between 1995 and 2001 was carried out. Diagnosis of MG was done clinically and with positive edrophonium or neostigmine test. Data concerning demographic and clinical characteristics were obtained from the case records. Results:The patients spent 10 - 36 days in the ICU. They were between the ages of 20 and 36 years; 4 females and 1 male. Seven episodes of cholinergic crisis and 4 episodes of myasthenic crisis were recorded with no mortality.
Conclusion:The use of standard protocols for management of post thymectomy MG would produce better results in terms of the number of cholinergic and myasthenic crises, and duration of respiratory support.

Keywords: Intensive care, Myasthenia gravis, Thymectomy

Journal of College of Medicine Vol. 13 (1) 2008: pp. 44-47