{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:57:09Z","timestamp":1790963829780,"version":"4.1.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Myasthenia gravis (MG) is a disorder of the neuromuscular junction that can deteriorate into myasthenic crisis, involving weakness of bulbar and respiratory muscles. In this study, we describe the clinical manifestations of myasthenic crisis, identify risk factors, and examine treatments and outcomes. All 95 patients with generalized MG treated at our center during the last 10 years were included in this retrospective study. We collected data from the patients' records, including clinical follow-ups, muscle antibodies, thymic status, and treatments. The characteristics of patients who did and did not experience myasthenic crisis were compared. Features of all myasthenic crises were also assessed. Twelve patients (13%) developed myasthenic crisis during the observation period. Men were more often affected at older ages. Seven patients experienced multiple myasthenic crises. Thymoma increased the risk of a crisis, whereas thymic hyperplasia decreased the risk. Myasthenic crises were more common in the summer months. No patients died during a myasthenic crisis. Risk factors for myasthenic crisis were thymoma, older age, MuSK antibodies, and previous crises. Individualized and active immunosuppressive treatment and optimal intensive care during crises provide a good outcome for patients with generalized MG.<\/jats:p>","DOI":"10.3389\/fneur.2023.1201451","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T02:11:25Z","timestamp":1689300685000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Occurrence and severity of myasthenic crisis in an unselected Turkish cohort of patients with myasthenia gravis"],"prefix":"10.3389","volume":"14","author":[{"given":"Selen","family":"Ozyurt Kose","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezgi","family":"Nazli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Tutkavul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils Erik","family":"Gilhus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/WCO.0000000000000473","article-title":"Myasthenia gravis: new developments in research and treatment","volume":"30","author":"Evoli","year":"2017","journal-title":"Curr Opin Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1056\/NEJMc1701027","article-title":"Myastheniagravis","volume":"376","author":"Gilhus","year":"2017","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1212\/WNL.0000000000002790","article-title":"International consensus guidance for management of myastheniagravis: executive summary","volume":"87","author":"Sanders","year":"2016","journal-title":"Neurology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1111\/j.1600-0404.2006.00609.x","article-title":"Myasthenia gravis: disease severity and prognosis","volume":"183","author":"Romi","year":"2006","journal-title":"Acta Neurol Scand Suppl."},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-10-46","article-title":"A systematic review of population based epidemiological studies in Myasthenia Gravis","author":"Carr","year":"2010","journal-title":"BMC Neurol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1002\/mus.26132","article-title":"Survival and mortality of adult-onset myasthenia gravis in the population of Belgrade, Serbia","volume":"58","author":"Basta","year":"2018","journal-title":"Muscle Nerve."},{"key":"B7","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1002\/mus.20950","article-title":"Lifetime course of myasthenia gravis","volume":"37","author":"Grob","year":"2008","journal-title":"Muscle Nerve."},{"key":"B8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/mus.24697","article-title":"Mortality in myasthenia gravis: a nationwide population-based follow-up study in Denmark","volume":"53","author":"Hansen","year":"2016","journal-title":"Muscle Nerve."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1212\/WNL.0b013e3181a41211","article-title":"Incidence and mortality rates of myasthenia gravis and myasthenic crisis in US hospitals","volume":"72","author":"Alshekhlee","year":"2009","journal-title":"Neurology."},{"key":"B10","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/978-1-59259-341-5_10","article-title":"Neurocritical care of myasthenia gravis crisis","author":"Filho","year":"2003","journal-title":"Myasthenia Gravis and Related Disorders"},{"key":"B11","doi-asserted-by":"publisher","first-page":"100063","DOI":"10.1016\/j.lanwpc.2020.100063","article-title":"Incidence, mortality, and economic burden of myasthenia gravis in China: a nationwide population-based study","volume":"5","author":"Chen","year":"2020","journal-title":"Lancet Reg Health West Pac."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e299","DOI":"10.1212\/WNL.0000000000008688","article-title":"Myasthenic crisis demanding mechanical ventilation: a multicenter analysis of 250 cases","volume":"94","author":"Neumann","year":"2020","journal-title":"Neurology."},{"key":"B13","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1111\/ene.12115","article-title":"Myastheia gravis treatment of acute severe exacerbations in the intensive care unit results in a favourable long-term prognosis","volume":"21","author":"Spillane","year":"2014","journal-title":"Eur J Neurol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1111\/ene.12703","article-title":"Myasthenia gravis: descriptive analysis of life threatening events in a recent nationwide registry","volume":"22","author":"Ramos Fransi","year":"2015","journal-title":"Eur J Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1111\/j.1468-1331.2010.03019.x","article-title":"Guidelines for treatment of autoimmune neuromuscular transmission disorders","volume":"17","author":"Skeie","year":"2010","journal-title":"Eur J Neurol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15872","article-title":"Efficacy of innovative therapies in myasthenia gravis: systematic review, meta-analysis and network meta-analysis","author":"Sacc\u00e0","year":"2023","journal-title":"Eur J Neurol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1111\/ene.14820","article-title":"Clinical characteristics and outcomes of thymoma-associated myasthenia gravis","volume":"28","author":"\u00c1lvarez-Velasco","year":"2021","journal-title":"Eur J Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"4042909","DOI":"10.1155\/2022\/4042909","article-title":"Camrelizumab-related lethal arrhythmias and myasthenic crisis in a patient with metastatic thymoma","volume":"2022","author":"Zhang","year":"2022","journal-title":"Case Rep. Cardiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s13256-020-02601-8","article-title":"Chemotherapy-induced myasthenic crisis in thymoma treated with primary chemotherapy with curative intent on mechanical ventilation: a case report and review of the literature","volume":"15","author":"Patelli","year":"2021","journal-title":"J Med Case Rep."},{"key":"B20","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1053\/j.semtcvs.2019.09.002","article-title":"Factors for the exacerbation of myasthenic symptoms after surgical therapy for myasthenia gravis and thymoma","volume":"32","author":"Kato","year":"2020","journal-title":"Semin Thorac Cardiovasc Surg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e6808","DOI":"10.7759\/cureus.6808","article-title":"Myasthenia gravis with elderly onset at advanced age","volume":"12","author":"Hernandez Fustes","year":"2020","journal-title":"Cureus."},{"key":"B22","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s12883-019-1384-5","article-title":"Myastenic crisis treated in a Chinese neurological intensive care unit: clinical features, mortality, outcomes, and predictors of survival","volume":"19","author":"Liu","year":"2019","journal-title":"BMC Neurol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"767961","DOI":"10.3389\/fneur.2021.767961","article-title":"Patients with myasthenia gravis with acute onset of dyspnea: predictors of progression to myasthenic crisis and prognosis","volume":"12","author":"Huang","year":"2021","journal-title":"Front Neurol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.30638\/eemj.2019.110","article-title":"Effects of environmental and weather conditions on myasthenia gravis \u2013 in search of the missing link","volume":"18","author":"Cuciureanu","year":"2019","journal-title":"Environ Eng Manag J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1002\/ana.26579","article-title":"Seasonal variation in neurologic hospitalizations in the United States","volume":"93","author":"Hamedani","year":"2022","journal-title":"Ann Neurol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e23251","DOI":"10.7759\/cureus.23251","article-title":"An Interesting case of fatal myasthenic crisis probably induced by the COVID-19 vaccine","volume":"14","author":"Sonigra K","year":"2022","journal-title":"Cureus."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e15581","DOI":"10.7759\/cureus.15581","article-title":"A case of COVID-19 vaccine causing a myasthenia gravis crisis","volume":"13","author":"Tagliaferri A","year":"2021","journal-title":"Cureus."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-56053-433-4.50033-X","article-title":"Neuromuscular junction disorders","author":"Dimitru","year":"2001","journal-title":"Electrodiagnostic Medicine"},{"key":"B29","first-page":"355","article-title":"Neuromuscular junction disorders and myopathies","author":"Amato","year":"2017","journal-title":"Samuel's Manual of Nurologic Therapoetics"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1201451\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T02:11:28Z","timestamp":1689300688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1201451\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,13]]},"references-count":29,"alternative-id":["10.3389\/fneur.2023.1201451"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1201451","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,13]]},"article-number":"1201451"}}