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Neurology 1999;52:629
© 1999 American Academy of Neurology
Brief Communications

Plasma exchange versus intravenous immunoglobulin treatment in myasthenic crisis

A. I. Qureshi, MD, M. A. Choudhry, MD, M. S. Akbar, MD, Y. Mohammad, MD, H. C. Chua, MD, A. M. Yahia, MD, J. A. Ulatowski, MD, PhD, D. A. Krendel, MD and R. T. Leshner, MD

From the Departments of Neurology at The Johns Hopkins Hospital (Drs. Qureshi, Chua, and Ulatowski), Baltimore, MD; Medical College of Virginia (Drs. Choudhry and Leshner), Richmond, VA; Emory University School of Medicine (Drs. Akbar, Mohammad, and Krendel), Atlanta, GA; and Medical College of Wisconsin (Dr. Yahia), Milwaukee, WI.

Address correspondence and reprint requests to Dr. Adnan I. Qureshi, Department of Neurosurgery, Millard Fillmore Hospital, 3 Gates Circle, Buffalo, NY 14209-1194.

We performed a retrospective multicenter chart review to compare the efficacy and tolerance of plasma exchange (PE) and intravenous immunoglobulin (IVIg) in treatment of 54 episodes of myasthenic crisis. After adjustment for other variables, PE (compared with IVIg) was associated with a superior ventilatory status at 2 weeks (partial F = 6.2, p = 0.02) and 1 month functional outcome (partial F = 4.5, p = 0.04). However, the complication rate was higher with PE compared with IVIg (13 versus 5 episodes, p = 0.07).




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