摘要
重症肌無力通常成年後發病，孩童重症肌無力並不多見。一半以上的重症肌無力以眼部問題為原始表現，包括眼瞼下垂、眼肌麻痺、斜視、複視……等。兒童時期眼睛的功能正在發育，故孩童眼部重症肌無力比起成人需要注意的事項更多，孩童重症肌無力分成三種，除了年輕型重症肌無力與成年人有相同病理機轉外，新生兒重症肌無力和先天性重症肌無力的病因，診斷，與治療各有其獨特性，需另予討論。由於孩童重症肌無力的臨床表現變異性太大，應加上抗膽鹼脂脢藥物測試、血中乙醯膽鹼接收器抗體或電生理學測試來幫助診斷。治療以抗膽鹼脂脢及免疫抑制劑等內科藥物治療為主，眼瞼下垂及斜視的矯正手術僅適用於極少數症狀穩定的病人。胸腺切除術是否適用於孩童，現今仍有爭議。
並列摘要
Myasthenia gravis most frequently affects adults. The onset in children is rare, and it also shows a more varied clinical picture in children than in adults. The rarity and variability of the manifestations of myasthenia gravis in children contributes to the difficulty of diagnosis. Children with myasthenia gravis are commonly misdiagnosed or treated incorrectly. Because many cases of childhood myasthenia are first seen in the ophthalmic clinic, ophthalmologists should pay special attention when seeing patients with ptosis or ophthalmoplegia. In this article, we review childhood myasthenia gravis with an emphasis on the ocular manifestations, diagnostic testing, and management of this disease.
延伸閱讀
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- 眼科部、兒童血液腫瘤科（2021）。四處尋醫仍須摘眼保命，視網膜母細胞瘤奪幼童眼球。彰基院訊，38(11)，8-9。https://www.airitilibrary.com/Article/Detail?DocID=P20140814001-202111-202111150006-202111150006-8-9
- 通識再現（2020）。孩子的視力嚴重惡化，「大人們」竟無視？。點教育，2(2)，9-11。https://www.airitilibrary.com/Article/Detail?DocID=P20200409001-202012-202101180014-202101180014-9-11
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