Predictive factors for myasthenic crisis after videoscopic thymectomy in patients with myasthenia gravis

Muscle Nerve. 2015 Aug;52(2):216-20. doi: 10.1002/mus.24531. Epub 2015 Mar 5.

Abstract

Introduction: 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.

Keywords: myasthenia gravis; myasthenic crisis; prognosis; thymectomy; videoscopic thymectomy.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myasthenia Gravis / diagnosis*
  • Myasthenia Gravis / surgery*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology
  • Predictive Value of Tests
  • Retrospective Studies
  • Thymectomy / adverse effects*
  • Thymectomy / trends
  • Video-Assisted Surgery / adverse effects*
  • Video-Assisted Surgery / trends
  • Young Adult