Faculty of Medicine, University of Queensland, Herston, Australia.
Princess Alexandra Hospital, Woolloongabba, Australia.
Semin Ophthalmol. 2023 Nov;38(8):727-736. doi: 10.1080/08820538.2023.2211134. Epub 2023 May 11.
Myasthenia gravis is an autoimmune condition affecting the neuromuscular junction of skeletal muscles and may be difficult to diagnose. Several clinical signs may have diagnostic utility, including Cogan's lid twitch. This systematic review aims to synthesise the literature on the accuracy of Cogan's lid twitch for diagnosing myasthenia gravis.
A systematic search of the databases PubMed/MEDLINE, Embase and CENTRAL was performed from inception to August 2022. Risk of bias analysis and data extraction were performed in accordance with the PRISMA 2020 guidelines.
Seven articles satisfied the inclusion criteria. The results showed that for the diagnosis of myasthenia gravis, Cogan's lid twitch has a sensitivity between 50% and 99% and specificity between 75% and 100%.
Cogan's lid twitch is a physical examination finding with moderate diagnostic performance in the diagnosis of myasthenia gravis with ocular involvement. Future studies may seek to evaluate the performance of Cogan's lid twitch in conjunction with other signs of myasthenia gravis with ocular involvements, such as fatigable ptosis or a positive icepack test.
重症肌无力是一种影响骨骼肌神经肌肉接头的自身免疫性疾病，可能难以诊断。一些临床体征可能具有诊断效用，包括 Cogan 氏眼睑抽搐。本系统评价旨在综合评估 Cogan 氏眼睑抽搐诊断重症肌无力的准确性。
从创建到 2022 年 8 月，我们对 PubMed/MEDLINE、Embase 和 CENTRAL 数据库进行了系统检索。根据 PRISMA 2020 指南进行了偏倚风险分析和数据提取。
有 7 篇文章符合纳入标准。结果表明，对于重症肌无力的诊断，Cogan 氏眼睑抽搐的敏感性在 50%至 99%之间，特异性在 75%至 100%之间。
Cogan 氏眼睑抽搐是一种体格检查发现，在伴有眼部受累的重症肌无力的诊断中具有中等诊断性能。未来的研究可能会评估 Cogan 氏眼睑抽搐与伴有眼部受累的重症肌无力的其他体征（如易疲劳性上睑下垂或冰袋试验阳性）联合使用的性能。
