Edrophonium-induced macrosaccadic oscillations in myasthenia gravis

Ann Neurol. 1999 Apr;45(4):522-5. doi: 10.1002/1531-8249(199904)45:4<522::aid-ana16>3.0.co;2-u.

Abstract

In a myasthenia gravis patient with profound ophthalmoplegia who was given edrophonium during forward fixation or horizontal/vertical saccades, horizontal macrosaccadic oscillations occurred that were conjugate, 2 to 3 Hz, and of peak-to-peak amplitude up to 50 degrees. The intersaccadic interval averaged 129.5 msec as measured by electro-oculography. Eye closure or the use of Frenzel goggles markedly reduced the amplitude and frequency of the macrosaccadic oscillations. This short latency is similar to that of a corrective saccade, and suggests that edrophonium induces macrosaccadic oscillations through a non-visually guided reflex saccade by temporarily unmasking the adaptively increased saccadic gain to overcome myasthenic ocular paresis.

Publication types

  • Case Reports

MeSH terms

  • Edrophonium / therapeutic use*
  • Electrooculography
  • Female
  • Humans
  • Middle Aged
  • Myasthenia Gravis / drug therapy*
  • Myasthenia Gravis / physiopathology
  • Saccades / drug effects*
  • Saccades / physiology

Substances

  • Edrophonium