UCL, Institute of Neurology, London, UK.
Eur J Neurol. 2014;21(1):171-3. doi: 10.1111/ene.12115. Epub 2013 Feb 11.
Acute severe exacerbations of myasthenia gravis (MG) are common in both early and late onset MG. We wished to examine the current management in the intensive care unit (ICU) of severe exacerbations of MG and to study the long-term prognosis of MG following discharge from the ICU.
We retrospectively reviewed the medical records of all patients admitted to a specialist neuro-ICU with acute exacerbations of MG over a 12-year period.
We identified 38 patients. Over 60% were over the age of 50 years, and MG was newly diagnosed in over 40%. Intubation was required in 63%, and over 90% of patients were treated with prednisolone and/or intravenous immunoglobulin. Four patients died in hospital. The remainder of patients were followed up for a mean of 4 years, and the majority were either asymptomatic or had mild symptoms of MG at clinical review.
Despite the significant morbidity and mortality associated with severe exacerbations of MG, specialized neurointensive care can result in a good long-term prognosis in both early- and late-onset MG.
重症肌无力（MG）的急性严重恶化在早发型和晚发型 MG 中均很常见。我们希望研究重症监护病房（ICU）中 MG 严重恶化的当前管理方法，并研究从 ICU 出院后 MG 的长期预后。
我们回顾性分析了 12 年间因急性 MG 恶化而入住神经科重症监护病房的所有患者的病历。
共纳入 38 例患者。超过 60%的患者年龄超过 50 岁，超过 40%的患者为新诊断的 MG。63%的患者需要插管，超过 90%的患者接受了泼尼松龙和/或静脉注射免疫球蛋白治疗。4 例患者在院死亡。其余患者平均随访 4 年，大多数患者在临床复查时无症状或仅有轻度 MG 症状。
尽管严重的 MG 恶化与显著的发病率和死亡率相关，但神经重症监护可使早发型和晚发型 MG 的长期预后良好。
