The long-term results of thymectomy in 24 children with generalized myasthenia gravis are reviewed. Sixteen had complete remission and another seven were improved. This compares favorably with reported spontaneous remission rates of 30%. Because of the low morbidity in recent reports and the possibility that early thymectomy is more beneficial, we recommend thymectomy at the onset of juvenile generalized myasthenia gravis. (J Child Neurol 1990;5:215-218).
Get full access to this article
View all access options for this article.
References
1.
1. Genkins G., Papatestas AE, Horowitz SH, et al: Studies in myasthenia gravis: Early thymectomy. Electrophysiologic and pathologic correlations. Am J Med1975 ;58:517-523.
2.
2. Buckingham JM, Howard FM, Bernatz PE, et al: The value of thymectomy in myasthenia gravis: A computer-assisted matched gravis. Ann Surg1974;184:453-457.
3.
3. Emeryk B., Strugalska MH: Evaluation of results of thymectomy in myasthenia gravis. J Neurol1976;211:155-168.
4.
4. Mulder DG, Hermann C., Kessey J., et al: Thymectomy for myasthenia gravis. Am J Surg1983;146:61-66.
5.
5. Papatestas AE, Genkins G., Koenfield P., et al: Effects of thymectomy in myasthenia gravis. Ann Surg1987;206:79-88.
6.
Keynes G.: Surgery of the thymus gland: Second and third thoughts. Lancet1954;1:1197-1202.
7.
7. Millichap JG, Dodge PR: Diagnosis and treatment of myasthenia gravis in infancy, childhood, and adolescence . Neurology1960;10:1007-1014.
8.
8. Fonkalsrud EW, Herrmann C., Mulder DG: Thymectomy for myasthenia gravis in childhood. J Pediatr Surg1970;5:157-165.
9.
9. Seybold ME, Howard FM, Drake DD, et al: Thymectomy in juvenile myasthenia gravis. Arch Neurol1971;25:385-392.
10.
10. Hansson O., Johansson L., Stalberg E., et al: Thymectomy in juvenile myasthenia gravis. Neuropadiatrie1972;3:429-436.
11.
11. Ryniewicz B., Badurska B: Follow-up study of myasthenic children after thymectomy . J Neurol1977;217:133-138.
12.
12. Snead OC, Benton JW, Dwyer D., et al: Juvenile myasthenia gravis. Neurology1980;30:732-739.
13.
13. Rodriguez M., Gomez MR, Howard FM, et al: Myasthenia gravis in children: Long term follow-up. Ann Neurol1983;13:504-510.
14.
Youssef S.: Thymectomy for myasthenia gravis in children. J Pediatr Surg1983;18:537-541.
15.
15. Campbell JR, Bisio JM, Harrison ME, et al: Surgical treatment of myasthenia gravis in childhood. J Pediatr Surg1983;18:857-861.
16.
16. Osserman KE, Genkins G: Studies in myasthenia gravis: Review of a twenty-year experience in over 1200 patients. Mt Sinai J Med1972 ;38:497-534.
17.
17. Laks H., Hammond GL: A cosmetically acceptable incision for the median sternotomy. J Thorac Cardiovasc Surg1980;79:146-149.
18.
Engel AG: Myasthenia gravis and myasthenia syndromes. Ann Neurol1984;16:519-534.
19.
Seybold ME: Myasthenia gravis: A clinical and basic science review. JAMA1983;250:2516-2521.
20.
20. Cox A., Lisak RP, Skolnik P., et al: Effect of thymectomy on blood T-cell subsets in myasthenia gravis . Ann Neurol1986;19:297-298.
21.
Fenichel GM : Clinical syndromes of myasthenia in infancy and childhood. Arch Neurol1978;35:97-103.
22.
Fukuyama Y. , Suzuki M., Segawa M.: Studies on myasthenia gravis in childhoodPediatr Univ Tokyo1970 ;18:57-68.
23.
23. Hudson CS, Rash JE, Tiedt TN, et al: Neostigmine-induced alterations at the mammalian neuromuscular junction: II. Ultrastructure. J Pharmacol Exp Ther1978;205:340-355.
24.
Mann JD, Johns TR, Campa JF, et al: Long term prednisone followed by thymectomy in myasthenia gravis : Ann NY Acad Sci1976;274:608-622.
25.
Jenkins RB: Treatment of myasthenia gravis with prednisone. Lancet1972;1:765-767.
26.
26. Snead OC, Kohaut EC, Oh SJ, et al: Plasmapheresis for myasthenia gravis in a young child. J Pediatr1987;110:740-742.
27.
27. Tindall RSA, Rollins JA, Phillips JT, et al: Preliminary results of a double-blind, randomized, placebo-controlled trial of cyclosporine in myasthenia gravis. N Engl J Med1987;316:719-724.
28.
28. Cooper JD, Al-Jilaihawa AN, Pearson FG: An improved technique to facilitate transcervical thymectomy for myasthenia gravis. Ann Thorac Surg1988;45:242-247.
29.
29. Jaretzki A., Penn AS, Younger DS, et al: "Maximal" thymectomy for myasthenia gravis. J Thorac Cardiovasc Surg1988;95: 747-757.