COURSE AND MANAGEMENT OF MYASTHENIA GRAVIS

Abstract

Since myasthenia gravis is a disease that is subject to spontaneous remissions and exacerbations, it is difficult to evaluate the effect of procedures that are intended to alter the course of this disease. There has been considerable difference of opinion concerning the effect of thymectomy¹ and of irradiation of the thymus.² Preliminary observations on the effect of thymectomy suggested that the rate and degree of remission following this operation were greater than would be expected to occur spontaneously.³ Because 12 years have elapsed since these observations were begun, a review of this problem, in which the course of patients who have had thymectomy or irradiation of the thymus are compared with patients of comparable severity of illness who have had neither procedure, seems appropriate. A total of 202 patients with generalized myasthenia gravis have been studied in the Johns Hopkins Hospital from 1 to 34 years, the