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Myasthenia Gravis

Myasthenia Gravis Relapse

03/03/2000

Question:

I am a 47 year old male with myasthenia gravis and, apparently, the success of remission after a thymetocy for me is rated very high. Almost three months ago, I had a thymectomy and was weaned off my medications completely(Prednisone and Mestinon). During the past week, however, diplopia (double vision) returned and severity is increasing daily. This really surprises me because I was completely off my medications and doing very well. Now I am back on Mestinon and taking much higher dosages than before (120 mg Q6h). Is this seemingly cured state followed by a relapse a common occurence in MG patients. Also, would my relapsed state be temporary or permanent?

Answer:

There is no cure for myasthenia and that is why doctors use the term `remission` in describing a resolution of symptoms in a patient no longer needing medications. Thymectomy is thought to increase the chance of remission, but again is not a cure. The thymectomy is thought to improve a patient`s chance of remission over the years. The course of myasthenia varies with each patient and patients do have a return of symptoms when tapered of Prednisone. So, my answer is that your situation is seen often. There is no way to predict what will happen with you, but effective treatment is available and you may need some modification in treatment.

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Response by:

Henry J Kaminski, MD Henry J Kaminski, MD
Formerly, Professor of Neurology
School of Medicine
Case Western Reserve University