Evoli A, Tonali P, Bartoccioni E, Lo Monaco M
Catholic University, Rome, Italy.
Acta Neurol Scand. 1988 Jan;77(1):31-5. doi: 10.1111/j.1600-0404.1988.tb06970.x.
Forty-eight patients with purely ocular myasthenia were studied. Tensilon test was positive in 46 patients (95%); decremental response from limb muscles was present in 24 patients (50%); anti-AChR antibodies were detected in 20 patients of 44 (45.5%). Twenty-two patients underwent thymectomy, 18 were given corticosteroids, 42 received AChE drugs. At the end of the observation period, 8% of the patients were in remission, 67% were improved, 25% were unchanged. In our experience, the diagnosis of ocular myasthenia relies mainly on clinical data; AChE drugs are not very effective in extrinsic ocular muscles; indications for thymectomy should be restricted to thymoma cases and, perhaps, to patients in the early stages of the disease, within the first year of onset; corticosteroids are effective in most cases, but relapses after withdrawal are not uncommon.
对48例单纯眼肌型重症肌无力患者进行了研究。腾喜龙试验在46例患者中呈阳性（95%）；24例患者（50%）出现肢体肌肉递减反应；44例患者中有20例（45.5%）检测到抗乙酰胆碱受体抗体。22例患者接受了胸腺切除术，18例给予皮质类固醇，42例接受抗胆碱酯酶药物治疗。在观察期结束时，8%的患者缓解，67%的患者改善，25%的患者病情无变化。根据我们的经验，眼肌型重症肌无力的诊断主要依靠临床资料；抗胆碱酯酶药物对外眼肌效果不佳；胸腺切除术的适应证应限于胸腺瘤病例，或许还应限于疾病发病第一年内的早期患者；皮质类固醇在大多数情况下有效，但停药后复发并不少见。
