Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2016
[Outcomes and treatment of myasthenic crisis].
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Kotov S V, Sidorova O P
Аннотация
AIM: The analysis of fatal outcomes of myasthenic crisis in patients with myasthenia.
MATERIAL AND METHODS: The data on 19 patients with myastheniccrisis admitted at the Moscow Regional Research and Clinical Institute («MONIKI») over 12 years (1997-2009) have been summarized.
RESULTS AND CONCLUSION: There are more than 600 patients with myasthenia in the Moscow region, including 13% patients with onset after 60 years. Seventeen patients of 19 were in the intensive care unit. Total death occurred in 7 cases (36.6%). Myocardial infarction, bilateral confluent pneumonia and hemorrhagic pulmonary edema caused death. All patients had concomitant diseases: hypertension, myocardial changes, hyperglycemia and others. Steroids and plasmapheresis were used for treatment of myasthenic crisis. The authors believe that methods of treatment of myasthenic crisis that does not lead to complications in elderly age and are suitable for patients with concomitant diseases, who can't be treated with glucocorticoids and plasmapheresis, should be used in clinical neurology. Normal human intravenous immunoglobulin is recommended in these cases.
MATERIAL AND METHODS: The data on 19 patients with myastheniccrisis admitted at the Moscow Regional Research and Clinical Institute («MONIKI») over 12 years (1997-2009) have been summarized.
RESULTS AND CONCLUSION: There are more than 600 patients with myasthenia in the Moscow region, including 13% patients with onset after 60 years. Seventeen patients of 19 were in the intensive care unit. Total death occurred in 7 cases (36.6%). Myocardial infarction, bilateral confluent pneumonia and hemorrhagic pulmonary edema caused death. All patients had concomitant diseases: hypertension, myocardial changes, hyperglycemia and others. Steroids and plasmapheresis were used for treatment of myasthenic crisis. The authors believe that methods of treatment of myasthenic crisis that does not lead to complications in elderly age and are suitable for patients with concomitant diseases, who can't be treated with glucocorticoids and plasmapheresis, should be used in clinical neurology. Normal human intravenous immunoglobulin is recommended in these cases.