Clinical and laboratory characteristics of five patients with an unusual variant of ocular myasthenia gravis
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | |
|---|---|---|---|---|---|
| *Episodes without corticosteroid therapy only. –, Absent or negative; AChR, acetylcholine receptor; F, female; M, male; MRI, magnetic resonance image. | |||||
| Clinical features | |||||
| Age at onset (years) | 40 | 50 | 44 | 37 | 63 |
| Sex | F | M | F | F | M |
| Prominent ptosis | – | – | + | – | – |
| Muscle fatiguability (at disease onset) | – | – | – | – | – |
| Subacute disease manifestation | + | + | + | + | + |
| Number of episodes | 7 | 5 | 2 | 4 | 4 |
| Mean duration of episodes (weeks)* | 3 | 12 | 2 | 9 | 6 |
| Generalisation | – | – | – | – | + |
| Concomitant diseases | – | – | Hypothyreosis | – | – |
| Diagnostic findings at disease onset | – | – | – | – | – |
| MRI lesions in orbita/cerebrum | – | – | – | – | – |
| Tensilon test | – | – | – | – | – |
| Decrement in repetitive nerve stimulation (5 Hz) | – | – | – | – | – |
| Anti-AChR antibodies | – | – | – | – | – |
| Diagnosis initially proposed | Midbrain lesion | Incomplete external oculomotor nerve paresis | Bilateral external oculomotor nerve paresis | Abducens nerve paresis | Tolosa-Hunt syndrome |