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Ocular myasthenia

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https://www.readbyqxmd.com/read/29689030/checkpoint-inhibitor-immune-therapy-systemic-indications-and-ophthalmic-side-effects
#1
Lauren A Dalvin, Carol L Shields, Marlana Orloff, Takami Sato, Jerry A Shields
PURPOSE: To review immune checkpoint inhibitor indications and ophthalmic side effects. METHODS: A literature review was performed using a PubMed search for publications between 1990 and 2017. RESULTS: Immune checkpoint inhibitors are designed to treat system malignancies by targeting one of three ligands, leading to T-cell activation for attack against malignant cells. These ligands (and targeted drug) include cytotoxic T-lymphocyte antigen-4 (CTLA-4, ipilimumab), programmed death protein 1 (PD-1, pembrolizumab, nivolumab), and programmed death ligand-1 (PD-L1, atezolizumab, avelumab, durvalumab)...
April 23, 2018: Retina
https://www.readbyqxmd.com/read/29683988/case-report-ocular-myasthenia-gravis-associated-with-in-vitro-fertilization-procedures
#2
Yung Ju Yoo, Sang Beom Han, Hee Kyung Yang, Jeong-Min Hwang
SIGNIFICANCE: Ocular myasthenia gravis is a localized form of myasthenia gravis, which is a postsynaptic disorder of the neuromuscular junction that causes fluctuating weakness of extraocular muscles resulting from autoimmune mechanisms. In women with myasthenia, changes in sex hormone levels and administration of corticosteroids can trigger or worsen symptoms of myasthenia gravis. PURPOSE: To describe a case of seronegative ocular myasthenia gravis whose first symptom appeared a day after in vitro fertilization procedure...
April 20, 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29655451/muscle-specific-tyrosine-kinase-and-myasthenia-gravis-owing-to-other-antibodies
#3
REVIEW
Michael H Rivner, Mamatha Pasnoor, Mazen M Dimachkie, Richard J Barohn, Lin Mei
Around 20% of patients with myasthenia gravis are acetylcholine receptor antibody negative; muscle-specific tyrosine kinase antibodies (MuSK) were identified as the cause of myasthenia gravis in 30% to 40% of these cases. Anti MuSK myasthenia gravis is associated with specific clinical phenotypes. One is a bulbar form with fewer ocular symptoms. Others show an isolated head drop or symptoms indistinguishable from acetylcholine receptor-positive myasthenia gravis. These patients usually respond well to immunosuppressive therapy, but not as well to cholinesterase inhibitors...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655449/diagnosis-of-myasthenia-gravis
#4
REVIEW
Mamatha Pasnoor, Mazen M Dimachkie, Constantine Farmakidis, Richard J Barohn
Myasthenia gravis (MG) diagnosis is primarily clinically based. By the end of the clinical evaluation, clinicians have a sense as to whether presenting symptoms and elicited signs are weakly or strongly supportive of MG. Diagnostic tests can reaffirm the clinicians' impression. Edrophonium testing is rarely used but helpful in cases of measurable ptosis. Decremental response on slow-frequency repetitive nerve stimulation has a modest diagnostic yield in ocular MG but is helpful in generalized MG cases. The most sensitive test is single-fiber electromyography...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655448/generalized-myasthenia-gravis-classification-clinical-presentation-natural-history-and-epidemiology
#5
REVIEW
Michael K Hehir, Nicholas J Silvestri
Myasthenia gravis (MG) is a rare disease, but the most common disorder of the neuromuscular junction. It is the prototypic autoimmune disease most commonly caused by antibodies to the acetylcholine receptor (AChR) leading to characteristic fatigable weakness of the ocular, bulbar, respiratory, axial, and limb muscles. The majority of patients with MG first present with ocular symptoms. Most patients with MG will experience at least 1 exacerbation of symptoms throughout the course of their illness. This article will cover the epidemiology, clinical presentation, classification, and natural history of MG...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29655447/ocular-myasthenia
#6
REVIEW
Mohammed Al-Haidar, Michael Benatar, Henry J Kaminski
Ocular myasthenia is a form of myasthenia gravis in which weakness is restricted to the ocular muscles and may produce significant visual disability. Patients present with fluctuating ptosis, diplopia, or a combination of both. Examination may show any type of ocular motility deficit ranging from isolated muscle palsy to complete ophthalmoplegia. Cogan lid twitch, enhanced ptosis, peek sign, and saccadic fatigue are specific examination findings that support the clinical diagnosis of myasthenia gravis. Confirmation of the diagnosis is challenging with autoantibody serology, and repetitive nerve stimulation studies are often negative...
May 2018: Neurologic Clinics
https://www.readbyqxmd.com/read/29569949/altered-expression-of-transcription-factors-irf4-and-irf8-in-peripheral-blood-b-cells-is-associated-with-clinical-severity-and-circulating-plasma-cells-frequency-in-patients-with-myasthenia-gravis
#7
Yong Zhang, Xiao Jia, Yan Xia, Hao Li, Fei Chen, Jie Zhu, Xiuying Zhang, Yanyan Zhang, YuZhong Wang, Yanan Xu, Meng Pan, Xiaoyu Huang, Tingyan Yu, Linlin Fu, Chenghua Xiao, Deqin Geng
Previous studies have shown that interferon regulatory factor-4 (IRF4) and IRF8 play critical but distinct roles in the differentiation of B cells into plasma cells (PCs). In the present study, we aimed to measure the expression levels of IRF4 and IRF8 in B cells from patients with myasthenia gravis (MG) and to investigate whether the expression of IRF4 and IRF8 associates with pathogenesis of MG. A total of 35 anti-acetylcholine receptor (AChR) antibody (Ab)-positive patients with MG [20 generalized MG (GMG) and 15 ocular MG (OMG) and 25 healthy donors were recruited in this study...
March 23, 2018: Autoimmunity
https://www.readbyqxmd.com/read/29555378/-an-update-on-myasthenia-gravis
#8
S Martínez Torre, I Gómez Molinero, R Martínez Girón
Myasthenia gravis is one of the most common disorders that affect neuromuscular transmission. It is currently one of the most understood and characterised autoimmune disorders Its typical symptoms are fluctuating weakness and fatigue that affects a combination of ocular muscles, bulbar functions, as well as limb and respiratory muscles, which are due to an immune attack against the postsynaptic membrane of the neuromuscular junction. The diagnosis of myasthenia gravis is based on clinical and serological test...
March 16, 2018: Semergen
https://www.readbyqxmd.com/read/29554816/ocular-surface-alterations-and-in-vivo-confocal-microscopic-characteristics-of-corneas-in-patients-with-myasthenia-gravis
#9
Kadriye Erkan Turan, Sibel Kocabeyoglu, Can Ebru Bekircan-Kurt, Figen Bezci, Sevim Erdem-Ozdamar, Murat Irkec
PURPOSE: To evaluate ocular surface alterations and characteristics of corneal basal epithelium and subbasal nerves in patients with myasthenia gravis. MATERIALS AND METHODS: Myasthenia gravis patients (n = 21) and healthy controls (n = 20) were enrolled. All participants underwent ocular surface testing in the following order: tear break-up time, lissamine green staining, Schirmer I test with anesthesia, and Ocular Surface Disease Index questionnaire. The Cochet-Bonnet esthesiometer was used to measure corneal sensitivity...
March 1, 2018: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/29535672/clinical-characteristics-of-juvenile-myasthenia-gravis-in-southern-china
#10
Xin Huang, Yingkai Li, Huiyu Feng, Pei Chen, Weibin Liu
Objectives: To describe the clinical profile, clinical outcomes and factors that may affect the outcome of juvenile myasthenia gravis (JMG) patients in southern China. Methods: We reviewed information relating to JMG patients treated and evaluated at the First Affiliated Hospital, Sun Yat-sen University, between 1998 and 2015. The study involved 327 JMG patients who had been followed up for ≥1 year. Results: Overall, 77.4% patients showed initial symptoms in the prepubertal period (<12 years)...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29518096/myasthenia-gravis-seronegative-for-acetylcholine-receptor-antibodies-in-south-korea-autoantibody-profiles-and-clinical-features
#11
Kee Hong Park, Patrick Waters, Mark Woodhall, Bethan Lang, Thomas Smith, Jung-Joon Sung, Kwang-Kuk Kim, Young-Min Lim, Jee-Eun Kim, Byung-Jo Kim, Jin-Sung Park, Jeong-Geon Lim, Dae-Seong Kim, Ohyun Kwon, Eun Hee Sohn, Jong Seok Bae, Byung-Nam Yoon, Nam-Hee Kim, Suk-Won Ahn, Jeeyoung Oh, Hyung Jun Park, Kyong Jin Shin, Yoon-Ho Hong
Acquired myasthenia gravis (MG) is a prototype autoimmune disease of the neuromuscular junction, caused in most patients by autoantibodies to the muscle nicotinic acetylcholine receptor (AChR). There seem to be ethnic and regional differences in the frequency and clinical features of MG seronegative for the AChR antibody. This study aimed to describe the autoantibody profiles and clinical features of Korean patients with generalized MG seronegative for the AChR antibody. A total of 62 patients with a high index of clinical suspicion of seronegative generalized MG were identified from 18 centers, and we examined their sera for antibodies to clustered AChR, muscle-specific tyrosine kinase (MuSK), and low-density lipoprotein receptor-related protein 4 (LRP4) by cell-based assays (CBA) and to MuSK by radioimmunoprecipitation assay (RIPA)...
2018: PloS One
https://www.readbyqxmd.com/read/29507855/pure-ocular-weakness-as-the-initial-manifestation-of-lambert-eaton-myasthenic-syndrome
#12
Nakul Katyal, Raghav Govindarajan
Pure ocular presentation of Lambert-Eaton syndrome is not a common phenomenon. Such presentation poses significant diagnostic challenges and requires conscientious evaluation. In this review, we have described a case of a patient with pure ocular weakness, initially diagnosed as seronegative ocular myasthenia which on further evaluation was found to have ocular Lambert-Eaton myasthenic syndrome (LEMS).
December 31, 2017: Curēus
https://www.readbyqxmd.com/read/29490884/repetitive-nerve-stimulation-and-jitter-measurement-with-disposable-concentric-needle-electrode-in-newly-diagnosed-myasthenia-gravis-patients
#13
Nermin Gorkem Sirin, Elif Kocasoy Orhan, Hacer Durmus, Feza Deymeer, Mehmet Baris Baslo
INTRODUCTION: The aim of this study was to define the diagnostic accuracy of concentric needle (CN)-jitter in newly diagnosed myasthenia gravis (MG) patients and to compare CN-jitter with repetitive nerve stimulation. METHODS: In 30 MG patients, repetitive nerve stimulation in 4 muscles (orbicularis oculi, nasalis, trapezius and abductor digiti minimi) and CN-jitter of extensor digitorum (ED) and frontalis muscles were evaluated. RESULTS: Twenty-eight of 30 patients (93%) had high jitter in at least one muscle...
February 25, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29455019/ocular-myasthenia-induced-by-rivaroxaban-in-patient-with-deep-vein-thrombosis
#14
Enrique M San Norberto, Irene García-Saiz, Diana Gutiérrez, Liliana Domingos, Carlos Vaquero
The non-VKA oral anticoagulant rivaroxaban is indicated in prevention and treatment of venous thromboembolism. A 60-year-old male patient complained of bilateral ptosis after administration of rivaroxaban for deep vein thrombosis. Myasthenia gravis was confirmed by positive serum antiacetylcholine receptor antibody test. No mediastinal thymoma was found. The ocular myasthenia reversed after discontinuing rivaroxaban treatment. Nevertheless, ptosis recurred and chronic oral pyridostigmine bromide treatment was necessary...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428956/prognosis-of-ocular-myasthenia-gravis-in-an-argentinian-population
#15
Florencia Aguirre, Andres M Villa
BACKGROUND: We investigated the prognosis of patients with myasthenia gravis (MG) initially presenting with only ocular symptoms in an Argentinian population. SUMMARY: We performed a retrospective analysis of 61 patients with MG with pure ocular involvement at onset. Generalized MG (gMG) developed in 73.7% of patients, while the rest only exhibited ocular symptoms throughout the course of the disease (ocular MG [oMG]). The AChR antibody (AChR-ab) was found in 81...
February 9, 2018: European Neurology
https://www.readbyqxmd.com/read/29342314/fatigue-is-a-relevant-outcome-in-patients-with-myasthenia-gravis
#16
Christopher Tran, Vera Bril, Hans D Katzberg, Carolina Barnett
INTRODUCTION: Patients with myasthenia gravis often experience fatigue, but its effect on quality of life (QoL) is underestimated, and fatigue is rarely measured in clinical trials. METHODS: Two hundred fifty-seven myasthenic patients completed the Neuro-QoL-Fatigue and measures of disease severity and QoL. We studied the relationship between fatigue and clinical and demographic variables. Finally, we studied the responsiveness of the Neuro-QoL-Fatigue in 95 patients receiving treatments for myasthenia and estimated the minimal important difference (MID)...
January 17, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29334041/autoantibodies-to-low-density-lipoprotein-receptor-related-protein-4-in-double-seronegative-myasthenia-gravis-a-systematic-review
#17
Stephen Bacchi, Philippe Kramer, Colin Chalk
BACKGROUND: Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction in which a clinical diagnosis may be confirmed with serological testing. The most common autoantibodies used to support a diagnosis of MG are anti-acetylcholine receptor antibodies and anti-muscle-specific tyrosine kinase antibodies. In cases in which both of these autoantibodies are negative (termed double-seronegative [dSNMG]), other autoantibodies such as low-density lipoprotein receptor-related protein 4 (LRP4) may be used to aid in diagnosis...
January 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29330628/clinical-and-cn-sfemg-evaluation-of-neostigmine-test-in-myasthenia-gravis
#18
Giorgia Sciacca, Ester Reggio, Giovanni Mostile, Alessandra Nicoletti, Filippo Drago, Salvatore Salomone, Mario Zappia
Neostigmine test (NT) is a pharmacological test, demonstrating a clinical improvement in patients affected by myasthenia gravis (MG). We aim to compare clinical evaluation and neurophysiological recordings by concentric-needle single-fiber electromyography (CN-SFEMG) in response to acute administration of neostigmine in ocular and generalized MG patients. Twenty-three MG patients (10 with ocular MG and 13 with generalized MG) were evaluated before and after 90 min neostigmine 0.5-mg administration. Clinical responsiveness was assessed by MG composite (MGC) scale...
February 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29286949/rating-scale-for-ocular-myasthenia-gravis-a-call-to-action
#19
Sui Hsien Wong
No abstract text is available yet for this article.
December 27, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/29232754/-measurement-of-the-strength-of-human-musculus-orbicularis-oculi-using-video-analysis
#20
Anita Koschmieder, Phillip Pisowocki, Carmen Zietz, Rainer Bader, Oliver Stachs, Anselm Jünemann
Introduction Current methods to measure the of strength of the musculus orbicularis oculi are limited by high proneness to examiner error or by their complex and impracticable set-ups. Our aim was to develop a simple and practicable method to measure eye lid power via video analysis. Methods 50 healthy subjects were included. A deformable single use lid speculum was used. Forced maximum lid closure was recorded via a video slit lamp. Analysis of the video data was performed with open source tracking software...
December 2017: Klinische Monatsblätter Für Augenheilkunde
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