Is Early Thymectomy a more prudent method of achieving a good clinical response in Myesthenia GravisA descriptive cross sectional study at Tertiary care level in Sri Lanka

Abstract

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Myesthesiag Gravis (MG) is a disease of the neuromuscular junction which demonstrates characteristic features of muscle weakness and fatigability of skeletal muscles.It carries a significant disease burden on quality of life . It is well documented that Thymoma has a significant association with MG Methods A descriptive cross sectional study was conducted on patients followed up for more than one year after disease presentation at the Neurology clinics of the North Colombo Teaching Hospital and National Hospital Colombo by one on one interviewer basis & assessment of medical records. Data was analyzed by using statistical software for social sciences version 23.0. Results The cohort of 65 patients with a mean age distribution of 51.65 (SD=11.6) consisted of M: F of 33:32 (50.8%= 49.2). Out of the 5 subclasses majority of the patients presented were in subclass 1 (N=34: 52%) & subclass 2 (N=19:29%) & all other classes combined 12 (18%). 55 patients were screened for thymoma & majority recording negative status class 1( 91.1%) class 2 ( 72%) with a p< 0.005. Out of the patients who underwent Thymectomy with or without thymoma had a significant improvement in symptoms p< 0,00. Conclusion The tendency for clinical improvement with Thymectomy seems significant in the Sri Lankan population and early surgery might be a suitable option for a better clinical response. Further analytical studies are needed to evaluate the significance of thymectomy in all patients with Myesthenia