Surgical management prospects for myasthenia gravis in Nigeria: A preliminary report of Enugu experience

Background: Myasthenia gravis (MG) is an acquired autoimmune neuromuscular disease characterized by fatigable and variable weakness of skeletal muscles as a result of autoimmune attack on postsynaptic antigenic targets. There is paucity of data on the outcome of treatment options available in resource-poor settings. Objective: The aim of this study was to determine the treatment outcome of surgical thymectomy for MG with regard to the local experience in Enugu, southeast Nigeria. Materials and Methods: It was a preliminary report of patients with MG seen at the Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu, Nigeria, from February 2016 to October 2019. The treatment outcomes of the patients were analyzed following thymectomy to determine the effectiveness of the surgical management. Data obtained included patients’ age, response to treatment, intensive care unit (ICU) stay, and total hospital stay. Results: The mean age of the patients was 35.7 ± 15.1. The mean duration of stay at the ICU was 3.9 ± 4.6 days, while the mean total hospital stay was 12 ± 9.70 days. All the patients (100%) had symptomatic improvement following thymectomy and 40% had remission. Conclusion: The general outcome of MG patients following thymectomy was favorable. Thymectomy appears to improve the prognosis of MG in the local setting of Enugu, Nigeria.