The levator palpebrae and extraocular muscles are preferentially affected by Myasthenia
Gravis (MG).[
[1]
] Approximately 50% of patients who do not have clinical dysfunction in the voluntary
muscles of the lower face, neck or below (Ocular Myasthenia Gravis—OMG) will develop
generalized disease (GMG), with the majority occurring within 1 year [
[2]
] and 80–90% within 2 years [
3
,
4
,
5
]. Recall that presence of abnormal serum acetylcholine receptor antibody and electromyogram
of muscles below the face is not a criterion for diagnosing GMG. Since to many neurologists,
diplopia and ptosis are not considered debilitating in comparison to potential complications
of immunomodulatory therapies and pyridostigmine is often considered sufficient therapy
until more serious disease arises [
[6]
]. Thus, the question is to find a therapy that reduces the tendency to develop GMG
and has a low risk of significant adverse effects. Additionally, few studies have
addressed the visual symptoms and ocular findings [
7
,
8
] such as diplopia and loss of depth perception that limit patient activities of daily
living such as driving.To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
October 28,
2003
Received:
October 28,
2003
Identification
Copyright
© 2003 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
