title: Contemporary management of myasthenia gravis: the clinical role of thymectomy.
abstract: Thirty-six patients with myasthenia gravis have been evaluated and treated over the past five years. Eleven patients had ocular myasthenia gravis and responded well to anticholinesterase medications. Twenty-five patients had generalized myasthenia gravis, and 22 of them were initially treated with anticholinesterase medications; 18(82%) failed to improve or to maintain an initial improvement on medication, and 14 of these 18 patients underwent thymectomy. In addition, 3 patients underwent thymectomy as part of their initial treatment during the later part of this study. All thymectomies were performed through a median sternotomy. All 17 patients manifested sustained improvement as judged by a gain in strength and decrease in medications. Thymectomy is beneficial in the treatment of myasthenia gravis, and it is most efficacious when performed early in the course of the disease.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000601:surgery*; D012075:Remission, Spontaneous; D013249:Sternum / Q000601:surgery; D013934:Thymectomy / Q000379:methods
chemical_list: D002800:Cholinesterase Inhibitors