Ocular myasthenia gravis and idiopathic orbital inflammatory disease: double the trouble!

Sharudin, Siti Nurhuda; Govindasamy, Gayathri; Mohamad, Nor Fadhilah; Kanesalingam, Ruban; Vasudevan, Suresh Kumar

doi:10.1016/j.jcjo.2017.07.024

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Our search of the relevant literature revealed three cases of combined MG and IOI. Two cases were categorized as ocular-type MG, and the MG and IOI symptoms were predominantly observed on the same side ( 3 - 5 ) ( Table ). In the present patient, the main inflammation was observed at the orbital periosteum, a finding that was not described in the previous reports.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Orbital Inflammation Appearing on the Affected Side of Preceding Myasthenia Gravis

et al. 2020

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The patient was a 70-year-old man with idiopathic orbital inflammation (IOI) that appeared on the severely affected side of preceding myasthenia gravis (MG). The patient was diagnosed with MG 5 years prior to the onset of IOI. When IOI was diagnosed, an edrophonium test was negative. IOI was considered because he complained of left orbital pain, eyelid swelling, and cerebral MRI exhibited the enhanced lesions along the left orbital periosteum. A biopsy specimen revealed pathological findings compatible with IOI. The administration of corticosteroids was effective for improving the ocular symptoms. IOI should be considered when ocular symptoms deteriorated with soft tissue swelling/pain in MG patients.

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Section: Discussionmentioning

confidence: 99%

Idiopathic Orbital Inflammation Appearing on the Affected Side of Preceding Myasthenia Gravis

et al. 2020

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Cavernous Sinus Meningioma Presenting with Unilateral Pseudo-Internuclear Ophthalmoplegia

Yoon¹,

Kim²

2022

Ann Optom Contact Lens

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Purpose: We report a case of cavernous sinus meningioma presenting with unilateral pseudo-internuclear ophthalmoplegia.Case summary: A 50-year-old female visited our clinic with a history of insidious onset of horizontal diplopia at primary and left gaze over 3 weeks. The symptom had diurnal variation and was aggravated with fatigue. There was intermittent upper eyelid drooping of the right eye. She had a history of migraines, which had recently worsened. The pupils showed a normal response to light and near stimulation in both eyes. The extraocular examination showed 14 prism diopter (PD) exotropia at primary, and 25 PD exotropia at left gaze, with -1 adduction limitation of the right eye. There was abducting nystagmus of the left eye. Ocular myasthenia gravis was suspected based on the clinical findings. Magnetic resonance imaging of the brain revealed a right cavernous sinus meningioma. The ocular symptoms improved after radiotherapy. At 3 months of follow-up, the ocular motility findings had improved to 4 PD exotropia, without adduction limitation of the right eye. The upper eyelid drooping had improved.Conclusions: A cavernous sinus meningioma can be manifested by various types of ocular motility disorder, including pseudo-internuclear ophthalmoplegia.

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Ocular myasthenia gravis and idiopathic orbital inflammatory disease: double the trouble!

Abstract: Incidence and prevalence of major central nervous system involvement in systemic lupus erythematosus: a 3-year prospective study of 370 patients.

Cited by 2 publications

References 8 publications

Idiopathic Orbital Inflammation Appearing on the Affected Side of Preceding Myasthenia Gravis

Idiopathic Orbital Inflammation Appearing on the Affected Side of Preceding Myasthenia Gravis

Cavernous Sinus Meningioma Presenting with Unilateral Pseudo-Internuclear Ophthalmoplegia

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