Summary
Records of 22 patients with myasthenia gravis treated at The Hospital for Sick Children, Toronto, between January 1957 and March 1972 were reviewed. Three cases of neonatal transient myasthenia gravis were treated with anticholinesterase drugs. Eleven patients with juvenile generalized myasthenia gravis and one with neonatal persistent myasthenia gravis underwent thymectomy.
The discontinuation of anticholinesterase treatment for at least 24 hours prior to operation and the use of small doses of edrophonium in the first four post-operative days decrease the incidence of complications. Complete remission occurred in four cases and objective improvement in eight. Thymectomy without elective tracheostomy is only possible with 24-hour intensive care facilities and constant medical supervision.
Résumé
Nous avons revu les dossiers de 22 malades souffrant de myasthénie grave et traités à l’hôpital “Sick Children” de Toronto entre janvier 1957 et mars 1972. Trois cas de myasthénie grave néonatale transitoire ont été traités avec des médicaments anticholinestérasiques. Onze malades souffrant de myasthénie grave juvénile généralisée et un malade souffrant de myasthénie grave néonatale persistante ont subi une thymectomie.
L’arrêt du traitement aux anticholinestérasiques durant au moins 23 hres avant l’opération et l’usage de petites doses d’édrophonium la première journée après l’opération ont diminué la fréquence des complications. Chez 4 malades il est résulté une rémission complète et, chez huit autres, une amélioration objective. La thymectomie sans une trachéotomie élective n’est possible que si l’on dispose des facilités des soins intensifs durant 24 heures et d’une surveillance médicale constante.
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Davies, D.W., Steward, D.J. Myasthenia gravis in children and anaesthetic management for thymectomy. Canad. Anaesth. Soc. J. 20, 253–258 (1973). https://doi.org/10.1007/BF03027163
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DOI: https://doi.org/10.1007/BF03027163