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University of Cambridge Neurology Unit, Addenbrooke's
Hospital, Hills Rd, Cambridge CB2 2QQ, UK
Correspondence to: Dr Neil Robertson, University of Cambridge Neurology Unit, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 2QQ, UK. Telephone 0044 1223 216751; fax 0044 1223 336941.
Received 24 October
1997 and in revised form 1 April 1998;
Accepted 6 April
1998
OBJECTIVES
To perform a comprehensive survey of
myasthenia gravis in the county of Cambridgeshire, England,
establishing contemporary epidemiological data.
METHODSCases were ascertained from multiple
sources. Prevalent patients were visited and assessed by means of a
standardised questionnaire and examination complemented by review of
medical case notes.
RESULTSOne hundred cases were identified in
a population of 684 000 (prevalence 15 per 100 000 population, 95%
confidence intervals (95% CIs) 12-18). Thirty eight new diagnoses
were made over a five year period providing an incidence of 1.1/100 000 population/year. The sex ratio was 2:1 F:M. After a mean follow up of
11.7 years, symptomatic disease was still restricted to ocular muscles
in 25 patients. Thirty four of 100 patients underwent thymectomy a mean
of 0.8 years after presentation, and a thymoma was present in 12. Highest remission rates were seen in patients presenting with
generalised disease who underwent thymectomy but did not have a thymoma
(27%). Cosegregation of an additional autoimmune disease occurred in
27 patients and in 24/49 (49%) women with onset<50 years of age.
CONCLUSIONSThis, the second highest reported
prevalence for myasthenia, is likely to be the result of optimum case
ascertainment, increased disease duration, application of complex
diagnostic tests, and the impact of an aging population leading to a
relative increase in the prevalence of ocular myasthenia.
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