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Ocular Myasthenia
Mohammed Al-Haidar1, Michael Benatar1, Henry J Kaminski1
1Department of Neurology, George Washington University, 2150 Pennsylvania Avenue, Northwest, Washington, DC 20037, USA; Department of Neurology, 1150 Northwest 14th Street #715, Miami, FL 33136, USA.
Abstract:
Ocular myasthenia is a form of myasthenia gravis in which weakness is restricted to the ocular muscles and may produce significant visual disability. Patients present with fluctuating ptosis, diplopia, or a combination of both. Examination may show any type of ocular motility deficit ranging from isolated muscle palsy to complete ophthalmoplegia. Cogan lid twitch, enhanced ptosis, peek sign, and saccadic fatigue are specific examination findings that support the clinical diagnosis of myasthenia gravis. Confirmation of the diagnosis is challenging with autoantibody serology, and repetitive nerve stimulation studies are often negative.
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