MYASTHENIA-GRAVIS IN THE ELDERLY - A HOSPITAL-BASED STUDY

To evaluate clinical characteristics and outcome of myasthenia gravis (MG) in aged patients (>60yrs), we retrospectively reviewed a continuo us series of 122 myasthenic patients observed from January 1968 throug h December 1994. Patients with congenital, neonatal, of penicillamine- induced myasthenia were excluded. Twenty-five subjects (20%) were >60y rs. The male/female ratio was 3.2; 20% of patients had an ocular form and 86% were seropositive. Mediastinum CT scan revealed thymic changes in 14%. During the first five years of disease, 60% of patients with ocular form progressed towards a generalized form and 15% had clinical relapses. At the time of their last visit, 40% of patients were asymp tomatic and 60% had improved on medication. No patient died because of myasthenia-related causes. This study shows that MG in aged patients is characterized by prevalence in males, low frequency of ocular forms , low frequency of positive mediastinum CT which suggests low frequenc y of thymomas, high frequency of progression of ocular forms, and good response to corticosteroid therapy.