Autoimmune Ocular Myasthenia Gravis: Diagnostic Utility of Autoantibodies to The Neuromuscular Junction in Eye Disorders

Myasthenia gravis (MG) is a rare autoimmune disorder affecting neuromuscular junction by muscleweakness. Myasthenia gravis can be generalized or localized as ocular myasthenia gravis. Casepresentation: We report an 8-year-old boy who presented with 10 days history of drooping of botheyelids and 8 days history of diplopia. Examination revealed bilateral ptosis. A diagnosis of JuvenileOcular Myasthenia gravis was made when symptoms improved with intramuscular Edrophoniumadministration. He was commenced on oral Neostigmine at a dose of 2mg/Kg/ day,4 hourly individed doses and is on regular follow up and had a good response. Conclusion: Ocular Myastheniagravis (OMG) is a rare disease in itself. A high index of suspicion is required in a juvenile as it iseven rarer.

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Update on Ocular Myasthenia Gravis

Seminars in Neurology ◽

10.1055/s-0039-1700527 ◽

2019 ◽

Vol 39 (06) ◽

pp. 749-760 ◽

Cited By ~ 1

Author(s):

Meabh O'Hare ◽

Christopher Doughty

Keyword(s):

Neuromuscular Junction ◽

Myasthenia Gravis ◽

Clinical Features ◽

Clinical Examination ◽

Autoimmune Disorder ◽

Therapeutic Options ◽

Diagnostic Approach ◽

Ocular Myasthenia ◽

Ocular Myasthenia Gravis ◽

Recent Developments

AbstractMyasthenia gravis is an antibody-mediated autoimmune disorder of the post-synaptic neuromuscular junction resulting in fluctuating, fatigable weakness. Most patients first present with extraocular symptoms (diplopia and/or ptosis), and in 15% of cases symptoms will remain restricted to only the extraocular muscles (ocular myasthenia gravis [OMG]). The history and clinical examination are of the utmost importance in correctly identifying OMG patients, as supportive serologic or electrodiagnostic studies are frequently nondiagnostic. In this review, we outline a diagnostic approach to OMG (focusing on key clinical features), discuss therapeutic options, and highlight recent developments in the understanding of OMG.

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Pure Ocular Myasthenia gravis

Neurology International Open ◽

10.1055/s-0043-122245 ◽

2018 ◽

Vol 02 (01) ◽

pp. E51-E55

Author(s):

Lukas Kirzinger ◽

Sophie Schötz ◽

Berthold Schalke

Keyword(s):

Neuromuscular Junction ◽

Myasthenia Gravis ◽

Diagnostic Procedure ◽

Cholinesterase Inhibitors ◽

Separate Entity ◽

Ocular Myasthenia ◽

Randomized Controlled ◽

Ocular Symptoms ◽

Randomized Controlled Studies ◽

Ocular Myasthenia Gravis

AbstractPure ocular myasthenia was always described as a separate entity in historical publications. More than 50% of patients develop generalized symptoms in the course of the disease. Therefore pure ocular symptoms can be the beginning of generalized myasthenia, nevertheless there is a small group of patients who suffer lifelong purely ocular symptoms. The basis, therefore, seems to be special immunological, biochemical and pathophysiological mechanisms leading to specific local changes of the neuromuscular junction. The diagnostic procedure is hampered as antibodies against acethylcholine receptors and MuSK can be demonstrated in less than 50% of these patients. Therapy of pure ocular myasthenia does not differ fundamentally from other subgroups of myasthenia gravis and is implemented with cholinesterase inhibitors, steroids and common immunosuppressants. Thymomectomy is not recommended in general, but randomized controlled studies are lacking.

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Abstract #1154: Ocular Myasthenia Gravis in the Setting of Graves’ Disease

Endocrine Practice ◽

10.1016/s1530-891x(20)44799-8 ◽

2016 ◽

Vol 22 ◽

pp. 277-278

Author(s):

Lima Lawrence ◽

Aleida Rodriguez ◽

Tahira Yasmeen ◽

Erin Drever

Keyword(s):

Myasthenia Gravis ◽

Graves Disease ◽

Ocular Myasthenia ◽

Ocular Myasthenia Gravis

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The diagnosis and management of ocular myasthenia gravis

East European Journal of Parkinson`s Disease and Movement Disorders ◽

10.33444/2414-0007.5.1-2.3-8 ◽

2019 ◽

Vol 5 (1-2) ◽

pp. 3-8

Author(s):

Gordon Plant

Keyword(s):

Myasthenia Gravis ◽

Severe Form ◽

Differential Diagnostics ◽

Diagnosis And Management ◽

Ocular Myasthenia ◽

Clinical Presentations ◽

Ocular Myasthenia Gravis

Ocular myasthenia is not the most severe form of myasthenia but it might cause certain difficulties to diagnose. In this article, we shall discuss the clinical presentations of ocular myasthenia, its differential diagnostics, examinations and management. Keywords: ocular myasthenia gravis, diagnosis, examination, management.

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