Surgical Management of Myasthenia Gravis

근무력증의 외과적 치료에 대한 임상적 고찰

Myasthenia gravis is a disorder that affects neuromuscular transmission in a way that is still poorly understood. some think that myasthenia gravis results from a reduction of available acetylcholine receptors in neuromuscular junctions, consequent to some form of autoimmune injury. Surgical interest in this disease was first aroused in 1939 when Blalock observed that some patients with thymic tumors and myasthenia gravis improved following thymectomy. This report represents two cases of myasthenia gravis. The 14-year-old girl was admitted to Korea Universtiy Hospital with chief complaintment of bilateral ptosis, diplopia, swallowing difficulty, and mastication difficulty, which were relieved by administration of edrophonium (Tensilon) chloride, given intravenously. Myasthenica gravis was confirmed and thymectomy was given. After thymectomy, symptoms were relieved but the administration of neostigmine was contijued to be needed till following 3 months. After that period, she was free from this symptoms without anticholinesterase drugs. Second case is 57 year old male who has the symptoms of diplopia, bilatreal ptosis, walking disturbance, and speech difficulty. He had thymectomy too but in thymic tissue, malignant thymoma was included. He has subjective improvement only, with no major reduction of medication requirements after thymectomy.