重症肌無力合併葛列夫兹氏眼疾之眼位變化－病例報告

Eye Position in Myasthenia Gravis Combined with Graves' Disease-Case Report

張雪麗(H.L. Chang) ； 黃嘉靜(J.J. Huang) ； 李錦輝(K.F. Li)

《中華民國眼科醫學會雜誌》 31卷1期 (1992/03) Pp. 58-62

https://doi.org/10.30048/ACTASOS.199203.0011

摘要

重症肌與力症志者之臨床眼位充滿變化，常須與多項腦神經麻痺引起之眼球運動障礙做鎰別診斷。而葛列夫玆氏眼疾(Graves' Disease)，即甲狀腺眼肌病變患者之臨床眼位則常以內斜視出現，且因肌肉受犯程度不一，有內轉或垂直運動受限之表徵。吾人報告一五十五歲男性病例，臨床表現為間歇性外斜視，要求手术治療。经詳問病史及理學檢查後，陸續接受斜視及複相檢查，內分泌檢驗及電腦斷層掃描等，證實為重症肌無力合併葛列夫玆氏眼疾。經投與類因醇及Mestinon治療，眼位及兩眼同視功能約有明顯改善，避免手術治療之可能性。因國內文獻未曾記載，故特別提出報告，以供參考。

並列摘要

The clinical eye position in myasthenia gravis is variable, and differential diagnosis with ophthalmoplegia caused by central nerve palsies is necessary. The eye position of Graves' ophthalmopathy used to manifest as esotropia, whicls may lead to adduction or vertical eye movement limitation. A 55 years-old male patient who presented as intermittent exotropia asked for surgical correction. In addition to detail history taken and physical examination, he also received strabismus examination, Hess chart, endocrine function test, and computerized tomography scan, etc. These results proved it as myasthenia gravis associated wills Graves' disease. Since Isis eye position and binocular vision improved apparently after treatment of corticosteroid and Mestinon, no surgery was undertaken. We present this case for reference due to it had never been recorded in Chinese medical journal.

並列關鍵字

Myasthenia gravis ； Graves' disease