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Ocular myasthenia: diagnostic and therapeutic problems
Author(s) -
Evoli A.,
Tonali P.,
Bartoccioni E.,
Monaco M. Lo
Publication year - 1988
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1988.tb06970.x
Subject(s) - thymectomy , ocular myasthenia , myasthenia gravis , medicine , thymoma , surgery , disease , aché , anesthesia , acetylcholinesterase , biochemistry , chemistry , enzyme
— Forty‐eight patients with purely ocular myasthenia were studied. Tensilon test was positive in 46 patients (95%); decremental response from limb muscles was present in 24 patients (50%); anti‐AChR antibodies were detected in 20 patients of 44 (45.5%). Tweny‐two patients underwent thymectomy, 18 were given corticosteroids, 42 received AChE drugs. At the end of the observation period, 8% of the patients were in remission, 67% were improved, 25% were unchanged. In our experience, the diagnosis of ocular myasthenia relies mainly on clinical data; AChE drugs are not very effective in extrinsic ocular muscles; indications for thymectomy should be restricted to thymoma cases and, perhaps, to patients in the early stages of the disease, within the first year of onset; corticosteroids are effective in most cases, but relapses after withdrawal are not uncommon.