Ocular myasthenia: clinical course and strategies for treatment
Introduction. Ocular myasthenia gravis is a localized form of myasthenia in which only the extra-ocular muscles are clinically affected, namely the levator palpebrae superioris and orbicularis oculi. Two years after onset of the ocular condition, it became generalized in 44-53% of the patients. Objective. 1. To describe the clinical features, diagnostic characteristics and clinical course of seven patients who fulfilled the criteria for diagnosis of ocular myasthenia and in whom the condition did not become generalized: 2. Review recent papers on this. Material and methods. We studied seven patients (two men and two women) diagnosed as having ocular myasthenia gravis, and followed them up for at least three years. Results. The average age was 56.5. The clinical findings were of ptosis of the eyelids and diplopia. All seven patients were treated with pyridostigmine. In six cases prednisone was also given and in one patient thymectomy was done. There was a satisfactory result in all cases. Conclusions. The basic treament for ocular myasthenia is with anticholinesterases and corticosteroids. Occasionally other immunosuppressives may be required. Prednisone seems to reduce the number of patients who go on to develop the generalized form
Objetivo 1. Describir las características clínicas, diagnósticas, evolutivas y el tratamiento de 7 pacientes con criterios diagnósticos de miastenia ocular y sin generalización posterior; 2. Revisar las últimas publicaciones al respecto. Material y métodos. Estudiamos a 7 pacientes (5 varones y 2 mujeres) diagnosticados de miastenia gravis ocular y a los que se hizo un seguimiento de al menos 3 años.
Resultados La media de edad era 56,5 años. Las manifestaciones clínicas fueron ptosis palpebral y diplopía. Los 7 pacientes recibieron tratamiento con piridostigmina; 6 casos, además, prednisona y en un paciente se llevó a cabo una timectomía. La evolución fue favorable en todos.
Conclusiones El tratamiento fundamental de la miastenia ocular lo constituyen anticolinesterásicos y corticoides; excepcionalmente se precisan otros inmunosupresores. La prednisona parece disminuir el porcentaje de pacientes que pasan de una forma ocular a generalizada