Clinical features and the course of Myasthenia gravis in the elderly patients

Abstract

Introduction: Myasthenia Gravis (MG) in the elderly is defined as onset after the age of 50 years. The incidence of late-onset MG without thymoma has been increasing in the last 20 years, in the USA and Europe. The increase is mainly found in patients over the age of 50 years. Recent data indicate that MG may still be substantially underdiagnosed in very old people (70 years). Purpose and objectives: To study the clinical features and the course of MG in elderly patients by performing a clinical trial and reviewing the medical literature. Material and methods: The clinical trial is based on 14 patients, older than 50 years old, with MG. It is a retrospective study, which included patients with MG, admitted to the Institute of Neurology and Neurosurgery between January 2009 and February 2014. Results and Conclusions: (1) Late-onset MG is seen more often in men than in women. The female-to-male ratio is near to 3:1 in late-onset MG. (2) Patients with late-onset MG exhibit few distinct clinical features that distinguish them from the early onset. (3) Although the disease activity tends to be lower and the prognosis favorable, they have a higher mortality than patients with earlyonset MG, and full remissions are rare. These findings probably relate to the presence of other comorbid conditions in the overall impact of MG in these patients.