Ocular myasthenia: diagnostic and therapeutic problems.
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%). Twenty-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.
Evoli
A
A
Catholic University, Rome, Italy.
Tonali
P
P
Bartoccioni
E
E
Lo Monaco
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D005128:Eye Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D011729:Pyridostigmine Bromide / Q000627:therapeutic use*; D011950:Receptors, Cholinergic / Q000276:immunology*; D013950:Thymus Gland / Q000601:surgery
D001323:Autoantibodies; D002800:Cholinesterase Inhibitors; D011950:Receptors, Cholinergic; D011729:Pyridostigmine Bromide