Edrophonium-induced macrosaccadic oscillations in myasthenia gravis
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Updated: Oct 23, 2026

Recording Horizontal Saccade Performances Accurately in Neurological Patients Using Electro-oculogram
Published on: March 13, 2018
A Komiyama1, H Toda, K Johkura
1Department of Neurology, Urafune Hospital of Yokohama City University, Yokohama, Japan.
Abstract:
In a myasthenia gravis patient with profound ophthalmoplegia who was given edrophonium during forward fixation or horizontal/vertical saccades, horizontal macrosaccadic oscillations occurred that were conjugate, 2 to 3 Hz, and of peak-to-peak amplitude up to 50 degrees. The intersaccadic interval averaged 129.5 msec as measured by electro-oculography. Eye closure or the use of Frenzel goggles markedly reduced the amplitude and frequency of the macrosaccadic oscillations. This short latency is similar to that of a corrective saccade, and suggests that edrophonium induces macrosaccadic oscillations through a non-visually guided reflex saccade by temporarily unmasking the adaptively increased saccadic gain to overcome myasthenic ocular paresis.
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