title: Predictive factors for myasthenic crisis after videoscopic thymectomy in patients with myasthenia gravis.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Hyung Seok
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Hyo Eun
authors.initials: HE
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Bae
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Young
authors.initials: KY
authors.lastname: Chung
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Ha Young
authors.initials: HY
authors.lastname: Shin
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Choi
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013934:Thymectomy / Q000009:adverse effects* / Q000639:trends; D020535:Video-Assisted Surgery / Q000009:adverse effects* / Q000639:trends; D055815:Young Adult
keywords: myasthenia gravis; myasthenic crisis; prognosis; thymectomy; videoscopic thymectomy