Ptosis Surgery on Chronic Myasthenia Gravis

重症肌無力在慢性穩定狀態時的眼瞼下垂手術

陳宏任(Hong-Jeng Chen) ； 翁林仲(Lin-Chung Woung) ； 周介仁(Jien-Ren Jou)

《The Kaohsiung Journal of Medical Sciences》 16卷2期 (2000/02) Pp. 95-99

https://doi.org/10.6452/KJMS.200002.0095

摘要

本篇報告三例早發性的重症肌無力病例，其臨床上都有眼瞼下垂、複視、輕度到中度非共慟性外斜視，對Neostigmine檢查呈陽性反應和顏面肌、口咽肌變弱。追蹤時間為五到九年平均為七年，並在最近兩年的追蹤當中，呈現對口服Pyridostigmine與類固醇治療近乎無效。其眼皮下垂與外斜視呈慢性穩定狀態。這三個病例，其眼球運動，最後在各個方向都有明顯限制，幾乎呈現僵直且眼瞼下垂。本篇報告探討其臨床上的罕見狀態，以及在肌電圖與病理上的發現。並為這三例進行Frontalis suspension手術，改善其眼瞼下垂，對其中一中度外斜視病例進行可調整性斜視手術治療其斜視，在手術後都超過一年半的追蹤當中，其療效相當良好。

並列摘要

We report three cases of long-standing, early onset myasthenia gravis. The eyes of all three patients eventually became disabled, and the patients were al. most unable to move their eyes in any direction. We termed this condition as ”frozen eyes” appearance. We discuss the unique clinical condition and follow the electromyographic and neuro-ophthalmological characteristics. The patients all suffered from ptosis, mild to moderate exotropia, and facial and oropharyngeal weakness. All of the patients responded to the neostigmine test positively at the early stage. 1\vo of them were seropositive. The results of electromyography for two of these three cases were abnormal. The average duration of follow-up Was 5 years. The treatments included conventional recession and resection procedures with adjustable sutures for strabismus and frontalis suspension for blepharoptosis. The patients achieved stable satisfactory results in over one-and-a-half years of postoperative follow up.

並列關鍵字

myasthenia gravis ； strabismus ； ptosis