Respiratory crisis after thymectomy in patients with myasthenia gravis.

The term "crisis," as applied to myasthenia gravis, usually implies failure of the muscles concerned with respiration, obstruction of the airway due to weakness of the laryngeal and pharyngeal muscles, and the accumulation of salivary and bronchial secretions. It is in these circumstances that apparent resistance to antimyasthenic drugs sometimes develops. In recent years, thymectomy has been established as a means of alleviating the signs and symptoms of myasthenia gravis. The operation has sometimes been followed by a period of respiratory crisis which has proved difficult to control. The present paper deals with the onset and treatment of crisis as it has occurred in four out of 10 patients subjected to thymectomy in the Thoracic Unit of Broadgreen Hospital, Liverpool.