EFNS/ENS Guidelines for the treatment of ocular myasthenia

E. Kerty; A. Elsais; Z. Argov; A. Evoli; N. E. Gilhus

doi:10.1111/ene.12359

journal article Jan 28, 2014

EFNS/ENS Guidelines for the treatment of ocular myasthenia

E. Kerty A. Elsais Z. Argov A. Evoli N. E. Gilhus

European Journal of Neurology Vol. 21 No. 5 pp. 687-693 · Wiley

View at Publisher Save 10.1111/ene.12359

Abstract

Background and purposeThe symptoms of acquired autoimmune ocular myasthenia are restricted to the extrinsic eye muscles, causing double vision and drooping eyelids. These guidelines are designed to provide advice about best clinical practice based on the current state of clinical and scientific knowledge and the consensus of an expert panel.Search strategyEvidence for these guidelines was collected by searches in the MEDLINE and Cochrane databases. The task force working group reviewed evidence from original articles and systematic reviews. The evidence was classified (I, II, III, IV) and consensus recommendation graded (A, B or C) according to the EFNS guidance. Where there was a lack of evidence but clear consensus, good practice points are provided.ConclusionsThe treatment of ocular myasthenia should initially be started with pyridostigmine (good practice point). If this is not successful in relieving symptoms, oral corticosteroids should be used on an alternate‐day regimen (recommendation level C). If steroid treatment does not result in good control of the symptoms or if it is necessary to use high steroid doses, steroid‐sparing treatment with azathioprine should be started (recommendation level C). If ocular myasthenia gravis is associated with thymoma, thymectomy is indicated. Otherwise, the role of thymectomy in ocular myasthenia is controversial. Steroids and thymectomy may modify the course of ocular myasthenia and prevent myasthenia gravis generalization (good practice point).

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150

Citations

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References

Details

Published: Jan 28, 2014
Vol/Issue: 21(5)
Pages: 687-693
License: View

Authors

E

E. Kerty

Department of Neurology Oslo University Hospital Oslo Norway; Faculty of Medicine University of Oslo Oslo Norway

A

A. Elsais

Department of Neurology Oslo University Hospital Oslo Norway; Faculty of Medicine University of Oslo Oslo Norway

Z

Z. Argov

Department of Neurology Hadassah‐Hebrew University Medical Center Jerusalem Israel

A

A. Evoli

Institute of Neurology Catholic University Roma Italy

N

N. E. Gilhus

Department of Clinical Medicine University of Bergen Bergen Norway; Department of Neurology Haukeland University Hospital Bergen Norway

Cite This Article

E. Kerty, A. Elsais, Z. Argov, et al. (2014). EFNS/ENS Guidelines for the treatment of ocular myasthenia. European Journal of Neurology, 21(5), 687-693. https://doi.org/10.1111/ene.12359

EFNS/ENS Guidelines for the treatment of ocular myasthenia

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