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Important issues about patient history for myasthenic patient
Clinical manifestation of myasthenia gravis(MG) patients at different ages
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MG typical case
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Index / Typical Cases /


Removal of thymoma combined with immune depressant for treatment of MG
A 59 year-old Palestinian man was admitted into our hospital on Aug. 11 2009, for complaining ptosis for 2 months and eating difficulty for 1 month. He was diagnosed with MG-IIB and thymoma. On Sep. 4 2009, the man was treated with thymusectomy and mediastinal fat desection, while pathological examination diagnosed the tumor as type B2 thymoma. Ptosis and bradymasesis occurred at intervals postoperatively. On Dec.7 2009, he was treated with cyclophosphamide and traditional Chinese medicine. The symptoms of MG were remarkably improved and he was asked to orally take cyclophosphamide with total amount of 10g after discharge.

A 28-year-old Russian girl was admitted into our hospital, who had manifestations of ptosis, binocular diplopia,bradymasesis, limbs weakness and liquid may also escape through the nose during attempted swallowing. The check presentation in the local hospital indicated prostigmin test positive and electromyogram positive. She was treated with pyridostigmine bromide, but its symptoms recurred. In face of such disease, she lost self-confidence and complained of insomnia and depression.
Finally her mother brought her to the department of MG in our hospital. She was treated by western medicine combined with traditional Chinese medicine, which was prescribed by director Wei of Department of Neurology and director Li shao-hua respectively. The symptoms improved remarkably after the first course of treatment. For further treatment, director Dou of Department of MG recommended extended thymectomy, as CT findings showed thymic hyperplasia. However, considering big scar and residue resulting from endoscope-assistant surgery, the girl was afraid to undergo the operation. Director Dou showed pictures of his former patients, which had incision of 7—8cm(compared with 20-30cm in her local hospital). What’s more, director Dou performed 400 operations, but 7 operations in her local hospital. Finally she decided to receive operation in our hospital.
In the periods of hospitalization, although the girl was left alone in our hospital as her mother gent back to Russia due to her grandfather’s pass-away, our hospital organized a special group to take good care of her, assigning nurse with good English-speaking and training doctors with good Russian-speaking to accompany her, arranging well-nourishing diet, etc. And successful operation was achieved, resulting in removing all glandular tissue, surrounding fat and adenoid tissue. She was discharged 7 days after operation, continuing taking western medicine and traditional Chinese medicine after discharge. At present, all her symptoms disappeared.

A 59-year-old woman, who was from Nanyang in Hebei province, visited the 301 hospital of PLA. She was told to take prednisone at dose of 30 mg per day, and pyridostigmine bromide 30 mg per day, resulting in little improvement. On Nov.19 2009, she attended the first visit to MG center of our hospital. She was also asked to continue taking medicine prescribed by 301 hospital, and add traditional Chinese medicine, resulting in remarkable improvement after 4-5days. Also, she continued taking traditional Chinese medicine after discharge and gradually stopped taking medicines like hormone and pyridostigmine bromide. Through long-range video diagnosis, she expressed appreciation to doctors and said she favorable with normal life.

A 6-year-old boy, who was from Shanghai, visited hospital for ptosis of left eye at Shanghai children’s hospital and Hua-shan hospital of Shanghai. He was diagnosed with MG at Hua-shan hospital. And then he was told to take pyridostigmine bromide, without notable changes in ptosis. On Dec.7 2004, he went to our hospital, and doctors told him to take traditional Chinese medicine, resulting in quick improvement in ptosis. Luckily, he was found recovery in left eye within one week, and recovery in both eyes within two weeks. He took the medicine for 4 months and showed complete recovery. No recurrence is observed at present.

A 47-year-old man visited our hospital, who was a primary school teacher. Three years ago, he presented with binocular diplopia, fatigable weakness involving left eye and alternating ptosis. Good effect was not achieved with the pyridostigmine bromide treatment. Through reexamination, he was diagnosed with ocular MG, and was remarkably improved by treatment of traditional Chinese medicine and acupuncture. On Jan.18 2010, he was discharged and lived normal life while continuing taking traditional Chinese medicine.

A 32-year-old woman presented with ptosis in left eye, and CT findings showed occupying lesion in right lung. She was undergone operation with which thoracic gland and surrounding fat were reserved. Pathological study indicated as AB type thymoma. Two days after operation, improvement was observed for ptosis in left eye, however, bradymasesis was observed 15 days after operation. Through reexamination, she was diagnosed with MG. Temporary remission was achieved after hormone impact treatment, but ptosis recurred in her left eye 2 months after stopping applying hormone impact treatment. She was recurred with ptosis in left eye and acataposis. Our doctors considered recurrence of MG, meanwhile, thymic hyperplasia was observed by CT findings, however, without recurrence of thymoma. In Apr. 2009, she was performed thymusectomy and mediastinal fat desection. At present, she is stable without recurrence.

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