Myasthenia gravis (MG): a preliminary report

Eighteen cases of MG admitted to the Neurology Unit, 7th April Hospital, Benghazi, Libya, over a period of three years October 1991 to December 1994 were reviewed. The female to male ratio was 2.6:1 (13 females and five males). The mean age of presentation was 13.3 years later for male patients compared to females (mean age of presentation in females was 26.5 years and in males 39.8 years). The average time interval between the onset of symptoms and diagnosis was 2.5 years. At the time of diagnosis 94.5 pc (17 cases) of the cases had generalized MG and 5.5 pc (one case) had ocular symptoms only. In 11.1 pc (two cases) of patients an association with thyroid disorder was observed. Repetitive nerve stimulation (RNS) test was abnormal in 83 pc (15 cases) of our cases. All cases were initially treated with anticholinesterase and 22.2 pc (four cases) also additionally required steroid therapy. Thymectomy was performed on eight cases, four of which had thymus hyperplasia. None of our cases had any thymoma. Of these eight cases, one case (12.5 pc) had complete remission, five cases (62.5 pc) were doing well with a reduced dose of anticholinesterase and +/- steroids. However, two cases (25 pc) required intermittent plasmapharesis and immunosuppressants in addition to anticholinesterase and steroids. These patients are obviously being followed up for long term outcome.