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Myasthenia Gravis

Ocular Myasthenia Gravis

11/08/2005

Question:

Today I`m 37 years old,12 years ago I have been diagnosed with Ocular Myasthenia gravis, Since than I control the double vision and dropped eye lid with steroides. Lately my phisician suggested to go through thymectomy and/or start treatment with Imuran. Should Ocular Myasthenia Gravis be treated with thymectomy?

Answer:

Ocular myasthenia can be treated with thymectomy and it can be effective, but it is not usually recommended for only ocular symptoms. Control with mestinon and steroids is usually enough. Some patients even decide that they would rather live with the ocular symptoms and stay away from the medications we use to treat the myasthenia because of all the lovely side effects. Steroids, after twelve years of use, have plenty of nasty side effects, including bone loss, infections, skin changes, fat deposition, adrenal gland suppression, high blood pressure, diabetes, glaucoma, cataracts, etc. Talk to your physician again about the options. Imuran is a medication I use comfortably, especially in people that are requiring long term immunosuppression, understanding that it also has side effects.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati