Myasthenia in Lomé University Hospital: Epidemiological, Clinical and Therapeutic Aspects

Objective: This study aimed to describe the clinical, therapeutic, and epidemiological characteristics of myasthenia gravis cases managed at the Teaching Hospitals of Lomé, Togo.Methods: This was a descriptive, retrospective study conducted in the neurology departments of the two Teaching Hospitals of Lomé from January 1, 2018, to December 31, 2023. Results: A total of 14 patients were identified, comprising 12 women and two men. The frequency of consultations for myasthenia gravis was 2.33 cases per year. The mean interval between the first symptoms and diagnosis was 29 months. Diplopia with or without ptosis (64.3%) and generalized muscle fatigue (21.4%) were the most common presenting features. At admission, nine patients (64.29%) had generalized myasthenia. The Prostigmin test was positive in all cases (100%). Anti-acetylcholine receptor antibodies were detected in 66.67% of patients, and electromyography revealed a decremental response in 78.57% of cases. Chest computed tomography identified a thymoma in 7.14% of patients. All patients received anticholinesterase therapy, while 7.14% were treated with corticosteroids and 7.14% with immunosuppressants. Clinical improvement was observed in 57.14% of cases, whereas 21.43% experienced a myasthenic crisis, and 21.43% were lost to follow-up.Conclusion: Myasthenia gravis is a rare chronic neuromuscular disease. Early recognition and appropriate management significantly improve the prognosis and quality of life of affected patients.