Differences between ocular and generalized myasthenia gravis: binding characteristics of anti-acetylcholine receptor antibody against bovine muscles

Hayashi, Masatoshi; Kida, Kaichi; Yamada, Itaru; Matsuda, Hiroshi; Tsuneishi, M.; Tamura, Osamu

doi:10.1016/0165-5728(89)90178-1

Cited by 10 publications

(7 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The implication is that the antibody binds to a different part of the receptor in the two different processes. A related finding in some studies, 17,27,28 but not all 29 is that patients with ocular myasthenia, including some with negative antibody titres in traditional assays using limb muscle, 28 have sera that react more strongly in assays using antigen derived from ocular muscles, whereas the opposite is true for patients with generalized myasthenia. 17 Physiological hypotheses cite differences in the structure and function of extra-ocular muscles.…”

Section: Immunological Reasonsmentioning

confidence: 99%

Ocular Aspects of Myasthenia Gravis

Barton¹,

Fouladvand²

2000

Semin Neurol

View full text Add to dashboard Cite

Ocular myasthenia gravis is a not uncommon autoimmune disorder causing diplopia, ptosis, and weakness of lid closure. The predilection of myasthenia for the ocular muscles may be related to differences between limb and extraocular muscles in either physiological function or antigenicity. Clinically, ocular myasthenia can mimic any form of pupil-sparing ocular motility disorder. Dynamic abnormalities of myasthenic eye movements may reflect the primary hallmarks of the disease, which are fatigability and variability in strength, or secondary adaptive effects by the central nervous system. Tests to confirm the diagnosis include edrophonium challenge, repetitive nerve stimulation, single-fiber electromyography (EMG) of the frontalis, and assays for antibody directed against the acetylcholine receptor: all are less sensitive for ocular myasthenia than for generalized myasthenia. There is a higher incidence of other autoimmune conditions in myasthenia, notably thymoma and thyroid dysfunction. The differential diagnosis includes other diseases of the neuromuscular junction, such as Lambert-Eaton syndrome and botulism. Treatment consists of symptomatic use of acetylcholinesterase inhibitors and immunosuppression with steroids or azathioprine. Between 50 and 70% of patients with ocular myasthenia will eventually develop generalized disease: there is some retrospective data that steroids or azathioprine may reduce this by about 75%. The role of thymectomy in ocular myasthenia remains unclear.

show abstract

Section: Immunological Reasonsmentioning

confidence: 99%

Ocular Aspects of Myasthenia Gravis

Barton¹,

Fouladvand²

2000

Semin Neurol

View full text Add to dashboard Cite

show abstract

“…"Fluctuation, " the hallmark of the disease and its clinical signs, often impedes the diagnostic process. Moreover, serologic antibody testing, as well as repetitive nerve stimulation of peripheral muscles is reported to be less sensitive in OMG as compared to generalized myasthenia gravis (MG), with sensitivity rates of approximately 50% vs. up to 90% (6)(7)(8)(9)(10)(11)(12). Edrophonium testing may cause fatal adverse events and is often unavailable outside specialized institutions.…”

Section: Ocular Myasthenia Gravis -A Diagnostic Challengementioning

confidence: 99%

Diagnosing Myasthenia Gravis With Repetitive Ocular Vestibular Evoked Myogenic Potentials

et al. 2020

View full text Add to dashboard Cite

Timely and accurate diagnosis of myasthenia gravis, particularly in patients with fluctuating, isolated ocular involvement, remains challenging. Serological antibody testing and repetitive nerve stimulation of peripheral muscles usually have low sensitivity in these patients. Edrophonium testing may cause adverse events, single-fiber electromyography (SFEMG) is time-consuming and both tests are often unavailable outside specialized institutions. Repetitive ocular vestibular evoked myogenic potential (roVEMP) stimulation has recently been introduced to facilitate the diagnosis of myasthenia gravis. Similar to repetitive nerve stimulation, roVEMPs detect muscle decrements with the benefit of being non-invasive and allowing for direct measurement of the extraocular muscles. This review summarizes the clinical evidence of the diagnostic value of roVEMP for myasthenia. Prospective clinical trials have demonstrated high sensitivity and specificity. RoVEMPs are of particular interest in challenging myasthenia subgroups with isolated ocular involvement, negative serology, and/or negative conventional electrophysiological results. Optimal roVEMP repetition rates of 20-30 Hz have been identified. This promising novel diagnostic tool merits further attention and investigation to establish its value as a clinical test for myasthenia.

show abstract

“…The sera that only reacted with en grappe endplates presumably were binding the fetal AChR. When bovine EOM and foot muscles are used as a source of antigen, no difference in antibody detection is evident; 43 however, the interspecies differences between the human and bovine AChR likely mask the significance of the type of muscle used for antigen preparation.…”

Section: Immunological Reaction Of Myasthenia Gravis To Extraocular Mmentioning

confidence: 99%

Acetylcholine Receptor Epitopes in Ocular Myasthenia^a

Kaminski

1998

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

Differences between ocular and generalized myasthenia gravis: binding characteristics of anti-acetylcholine receptor antibody against bovine muscles

Cited by 10 publications

References 16 publications

Ocular Aspects of Myasthenia Gravis

Ocular Aspects of Myasthenia Gravis

Diagnosing Myasthenia Gravis With Repetitive Ocular Vestibular Evoked Myogenic Potentials

Acetylcholine Receptor Epitopes in Ocular Myasthenia^a

Contact Info

Product

Resources

About

Differences between ocular and generalized myasthenia gravis: binding characteristics of anti-acetylcholine receptor antibody against bovine muscles

Cited by 10 publications

References 16 publications

Ocular Aspects of Myasthenia Gravis

Ocular Aspects of Myasthenia Gravis

Diagnosing Myasthenia Gravis With Repetitive Ocular Vestibular Evoked Myogenic Potentials

Acetylcholine Receptor Epitopes in Ocular Myastheniaa

Contact Info

Product

Resources

About

Acetylcholine Receptor Epitopes in Ocular Myasthenia^a