Naslov
Diurnal fluctuating ophthalmoplegia and ptosis - is it only myasthenia gravis?

Autori
Zavoreo, Iris ; Knežević, Marija ; Blažić Čop, N. ; Demarin, Vida

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
European Journal of Neurology, Vol.15, Suppl.3 / Lenzi Gian Luigi, Gil-Nagel Antonio - : Wiley-Blackwell, 2008, 160-160

Skup
12th Congress of the European Federation of Neurological Societies

Mjesto i datum
Madrid, Španjolska, Spain

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
ophthalmoplegia; ptosis; myasthenia gravis

Sažetak
A young female patient was admitted to our department due to bilateral ptosis and diplopia she suddenly felt 2 weeks prior to admission. Symptoms were worse and frequent at the end of the day. Her family and past history were unremarkable. She had partial palsy of the left and right oculomotor nerve and complete palsy of the left trochlear and abducens nerve. Visual fields and visual acuity was not impaired. There was no pain in and behind the eyes, ocular fundus was clear. EKG, EEG, CDFI, and laboratory workup were normal. CT scan of the chest has shown anterior mediastinal mass adjacent to the aortic arch-1.7x1 cm highly suggestive of thymoma. Repetitive stimulation studies showed no evidence of decrement at baseline. Prostigmin test was partially positive ; there was resolution of symptoms on the left eye, with poor reaction on the right eye. Pyridostigmine bromide was introduced 2x60 mg per day, symptoms on the right eye were still present, therefore we performed brain MR which has shown intrasellar isodense mass with extension to right cavernous sinus and compressive effect on the right abducens, trochlear and oculomotor nerve. The patient was advised to consult a neurosurgeon about removal of pituitary tumour and after that an oncologist about thymectomy. Myasthenia gravis, although a systemic disease may present with only ocular symptoms in almost 50% of cases, sometimes patients can have another underlying condition such as pituarity adenoma. In that case, follow-up should be performed and in patients with persisting symptoms we should expand routine workup.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA