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  会員専用

• ホーム
• 47巻11号
• 臨床神経, 47：875−876, 2007
• 47巻11号目次

第48回日本神経学会総会

＜シンポジウム5-2＞免疫性神経疾患治療のControversy: 1. MG, 2. MS
重症筋無力症における胸腺手術の適応とその術前術後対策に関する現在と将来への展望

村井　弘之

飯塚病院神経内科〔〒820-8505　飯塚市芳雄町3-83〕

First, we studied clinical effects of thymectomy on non-thymomatous ocular myasthenia gravis (MG) patients by comparing operative and non-operative groups. The QMG scores reduced with similar significances in both groups. Thymectomy is considered to be unnecessary in non-thymomatous ocular MG. Second, we discussed over the issue how elderly-onset MG patients could be treated. We believe that thymectomy is sufficiently tolerable and therefore could be selected with low dose oral prednisolone in moderate to severe MG cases. However we should be aware of various complications which are common in elderly patients. In mild cases, we can treat with anti-cholinesterase only. Third, we compared the long term effect of endoscopic thymectomy (infrasternal mediastinoscopic thymectomy) with conventional transsternal method. QMG scores and anti-AChR antibody titers reduced in both groups with similar significances suggesting that endoscopic thymectomy is as effective as transsternal thymectomy in treating MG.

(臨床神経, 47：875−876, 2007)
key words：重症筋無力症, 胸腺摘除術, ステロイド, 免疫抑制薬

（受付日：2007年5月16日）