Myasthenia gravis is a rare, auto-immune disease marked by fatigable weakness of striated muscles. Both ocular and systemic forms of myasthenia are seen, so that intermittent, variable ptosis, diplopia, proximal muscle weakness, poor deglutition, and dyspnea are all encountered; however, as some myasthenics present (at least initially) with ptosis alone, the disease remains a diagnostic consideration in nearly all patients with ptosis who present for oculoplastic assessment. Diagnosis is aided by a history of diurnal, fatigable symptoms; characteristic examination findings; serological assays for myasthenia-related auto-antibodies; electromyography; and response to trial treatment. Diagnostic imaging, both to look for thymoma and to rule out neurosurgical disease, is commonly performed. Usual treatment options are acetylcholine potentiators and immunosuppression. Some patients, however, may require thymectomy, plasmapheresis, or respiratory support.
KeywordsMyasthenic Crisis Eyelid Retraction Chronic Progressive External Ophthalmoplegia Myasthenic Patient Chronic Progressive External Ophthalmoplegia
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