Ocular myasthenia gravis

Neil C. Porter, Brian Salter

Research output: Contribution to journalArticle

Abstract

Myasthenia gravis (MG) is an autoimmune disorder characterized clinically by proximal weakness and bulbar symptoms and pathologically by damage to the post-synaptic membrane at the neuromuscular junction. Ocular myasthenia gravis (ocular MG) is a form of myasthenia gravis whereby the patients' weakness is limited to the muscles of the eyes and eyelids (levator palpebrae superioris). Although not life-threatening, the limitations posed by ocular myasthenia gravis can prove disabling and distressing to patients. Acetylcholinesterase inhibitors such as pyridostigmine or neostigmine are the preferred first-line treatment for ocular myasthenia gravis, with mild cases requiring no additional intervention. However, in moderate or severe cases, treatment must be tailored to the needs and desires of the patient. Intravenous immunoglobulin, although costly, is safe and effective at treating MG. Corticosteroids are effective at reducing or eliminating symptoms and may modify the long-term course of the illness. Steroid-sparing agents such as azathioprine and mycophenolate mofetil are reasonably safe and well-tolerated alternatives to steroids. Surgical interventions such as strabismus surgery and eyelid suspension serve to correct impairments refractory to medical management. Thymectomy, although less frequently recommended, is a reasonable consideration, especially for young adults, given the potential for long-term benefit.

Original languageEnglish (US)
Pages (from-to)79-88
Number of pages10
JournalCurrent Treatment Options in Neurology
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

Fingerprint

Myasthenia Gravis
Eyelids
Oculomotor Muscles
Steroids
Pyridostigmine Bromide
Mycophenolic Acid
Neostigmine
Synaptic Membranes
Thymectomy
Neuromuscular Junction
Strabismus
Intravenous Immunoglobulins
Cholinesterase Inhibitors
Azathioprine
Young Adult
Suspensions
Adrenal Cortex Hormones
Muscles
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Ocular myasthenia gravis. / Porter, Neil C.; Salter, Brian.

In: Current Treatment Options in Neurology, Vol. 7, No. 1, 01.01.2005, p. 79-88.

Research output: Contribution to journalArticle

Porter, Neil C. ; Salter, Brian. / Ocular myasthenia gravis. In: Current Treatment Options in Neurology. 2005 ; Vol. 7, No. 1. pp. 79-88.
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