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DOI: 10.1055/s-2004-812718
Okuläre Myasthenie: eine diagnostische und therapeutische Herausforderung - eine Übersicht
Ocular Myasthenia: A Diagnostic and Management Challenge - A ReviewPublication History
Manuskript-Eingang: 8. September 2003
Annahme nach Revision: 11. Dezember 2003
Publication Date:
21 September 2005 (online)
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Zusammenfassung
Hintergrund: Die okuläre Myasthenie ist eine lokalisierte Form der Myasthenie, die klinisch die extraokularen Muskeln, den M. levator palpebrae superioris und/oder den M. orbicularis oculi, betrifft. Daraus ergibt sich eine Vielfalt an Symptomen, die verschiedenste periphere und supranukleäre Augenmuskel- und Lidlähmungen vortäuschen können. Material und Methode: Diese Analyse der wichtigsten Literatur der vergangenen Jahre konzentriert sich auf diagnostische Tests, die vor allem bei Acetylcholinrezeptor-Antikörper negativen Patienten hilfreich sind. Diskutiert werden therapeutische Richtlinien und zukünftige Behandlungsstrategien. Schlussfolgerungen: 50 - 80 % der Patienten mit Myasthenie stellen sich anfänglich als reine okuläre Erkrankung dar. Die klinischen Manifestationen, diagnostischen Möglichkeiten und Behandlungen werden im Hinblick auf die bei frühzeitiger Erkennung bessere Prognose dargestellt.
Abstract
Background: Ocular myasthenia is a localised form of myasthenia clinically involving the extraocular muscles, the m. levator palpebrae superioris and the m. orbicularis oculi. Various symptoms can masquerade peripheral and supranuclear eye muscle palsies and ptosis. Materials and method: This literature review of recent years focusses on the diagnostic tests that may be helpful to confirm myasthenia especially in patients without acetylcholine receptor antibodies. Conclusions: Ocular dysfunction accounts for 50 - 80 % of the initial manifestation of myasthenia gravis. Clinical manifestations, diagnostic tests and treatment assessment are reviewed. Early recognition of the disease is important for better prognosis.
Schlüsselwörter
Okulär - Myasthenia gravis - Überblick
Key words
Ocular - myasthenia gravis - review
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Univ.-Prof. Dr. Andrea Langmann
Universitäts-Augenklinik, Medizinische Universität Graz
Auenbruggerplatz 4
8036 Graz
Österreich
Email: andrea.langmann@uni-graz.at