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Myasthenia gravis
Neuro-Ophthalmology
Key Points
- •MG is an autoimmune disorder of the NMJ causing fatigable weakness that worsens with use and improves with rest; pupil is NEVER involved
- •Anti-AChR antibodies positive in ~85% generalized and ~50% ocular MG; SF-EMG is the most sensitive test (92–99%)
- •50% of ocular MG generalizes within 2 years; if purely ocular >2 years, generalization risk drops to <10–15%
- •Pyridostigmine (30–60 mg q4–6h) is first-line; corticosteroids with 'start low, go slow' principle; thymectomy indicated for thymoma and generalized AChR+ MG (MGTX trial)
- •Ice test (≥2 mm improvement after 2 min) is the most practical bedside test; Cogan lid twitch is near-pathognomonic
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Keep reading Myasthenia gravis
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations