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Juvenile myasthenia gravis

Department of Pediatrics, (Drs. Snead and Benton), Neurology (Dr. Oh) and the Neuroscience Program (Drs. Snead, Benton, and Bradley, and Mr. Dwyer), the University of Alabama School of Medicine, Birmingham, AL.

We studied 32 children with myasthenia gravis over a period of 12 years. The mean age at onset was 7.7 years. Presentation was ocular in 63% of patients. Another major disease in addition to myasthenia occurred in 44% of patients; a seizure disorder was the most commonly associated disease. Serum IgG antibody to nicotinic acetylcholine receptor was present in 53% of patients and did not correlate with severity of disease or treatment. Medical management was effective in 63%; thymectomy was effective in only 28%. We conclude that myasthenia gravis appears commonly before age 10 and is associated with the risk of some disease other than hyperthyroidism. Serum IgG nicotinic acetylcholine receptor antibody is present less frequently than in normal adults, and vigorous medical management should be attempted before thymectomy.

Address correspondence and reprint requests to Dr. Snead, Room 202, The Children's Hospital, 1601 6th Avenue South, Birmingham, AL 35233.

Accepted for publication October 2, 1979.

Presented in part at the thirty-first annual meeting of the American Acadamy of Neurology, Chicago, IL, April 1979.

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