DR. DILRASH ADOOR

DR. BHARATHI NARASIMHA MURTHY, DR. SWETHA KUMARI. C

Abstract

Purpose

A case report of ocular-myasthenia-gravis in a young man with autoimmune thyroid disorder

Methods

A 21year-old male presented with diplopia, ptosis& reduced eye movement in left eye for 8months which aggravated as the day progressed with a history of improvement in cold weather. He had 6/6 vision. Left eye had ptosis, positive Cogan’s lid twitch, fatigue test & ice pack test. Diplopia charting showed intermittent crossed diplopia. Anti-acetylcholine receptor& Anti-Muscle Specific Kinase antibody were negative. Anti-Thyroid peroxidase antibody was positive. Rapid nerve stimulating test showed decremental response of >10% in left orbicularis oculi, suggestive of post-synaptic conduction defect

Results

He was advised prisms for correction of diplopia& close follow up to monitor progression of symptoms. His symptoms improved with this treatment

Conclusions

In literature, it is reported only in 4-5% of myasthenia-gravis associated autoimmune thyroid disorder as in our case