Treatment of myasthenia gravis: a surgical profile

Twenty three cases of thymectomy were performed in Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2004-2006 for myasthenia gravis, age ranging from 18 to 65 years, male were 16 and female 07. Out of these cases 09 had thymoma of which 03 have shown features of malignancy. There was no pre-operative or post operative mortality. Thymectomy in myasthenia gravis was considered when there was clinical feature of drooping eye lids, difficulty in deglutition, nasal voice, generalized weakness etc. All patients received medical treatment before and after surgery. Medical treatment usually given at BSMMU anticholinesterase such as mastinon, if the patient is improved and well tolerated, this regime is continued. Although, role of steroid and immunosuppressive agents for the treatment of myasthenia gravis is controversial, steroid used in few cases of type II & type III. No steroid used in ocular variety. Patients were followed for one year and showed significant improvement after surgery.