Tsuda Hiromasa, Kamei Satoshi, Mizutani Tomohiko, Saito Noriko, Ishikawa Hiroshi, Omori Kazumitsu
Division of Neurology, Department of Medicine, Nihon University School of Medicine.
Rinsho Shinkeigaku. 2003 Aug;43(8):500-2.
We report a rare case of a 70-year-old woman diagnosed as having blepharospasm with positive anti-acetylcholine receptor antibody. Blepharospasm developed in November, 2000, and increased in frequency, and worsened toward the evening. She complained of difficulty in her eyelid opening from October, 2002. Neurological examinations revealed blepharospasm and mild ptosis in both eyes. Tensilon test was negative. Waning and waxing were not detected in bilateral orbicularis oculi muscles by Harvey-Masland test. However, anti-acetylcholine receptor antibody was positive and thymoma in the anterior mediastinum was also found by the computed tomography of the chest. After the thymectomy, frequency of blepharospasm decreased. When blepharospasm worsened toward the evening, the co-existence of myasthenia gravis should be borne in mind.
我们报告了一例罕见病例，一名70岁女性被诊断为患有抗乙酰胆碱受体抗体阳性的睑痉挛。睑痉挛于2000年11月出现，频率增加，且傍晚时加重。她自2002年10月起诉说睁眼困难。神经系统检查发现双眼睑痉挛和轻度上睑下垂。腾喜龙试验为阴性。哈维-马斯兰试验未检测到双侧眼轮匝肌的强弱变化。然而，抗乙酰胆碱受体抗体呈阳性，胸部计算机断层扫描还发现前纵隔有胸腺瘤。胸腺切除术后，睑痉挛的频率降低。当睑痉挛在傍晚时加重时，应考虑重症肌无力的并存情况。
