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Myasthenia Gravis

Double vision

03/29/2007

Question:

I have double vision had it 24/7 since June06.had tests done for MG.sf.emg negative,blood tests clear.chest x-ray clear.ctscan not my eyes.Need neuro.said MG.symptoms more like MS I think.Surely its not right for some one to have double vision permenantly all day,all night.On no medication will not give any until Iam diagnosed.MRI next month.Iam worried in case of damage to my eyes and that I might lose my sight.None of the DRs will talk to me proerly.

Answer:

Myasthenia gravis is a disorder of the connection between the nerve and the muscle. Typical symptoms include double vision (not just blurry vision), difficulty chewing, difficulty swallowing, difficulty breathing, ptosis (droopy eyelids), weak arms and legs. Symptoms are intermittent, waxing and waning. Fatiguing of muscles is a hallmark of the disease. Fixed double vision, that is always the same (meaning not fluctuating and usually with one specific direction), would make me concerned not for myasthenia, but more for another process, such as an oculomotor nerve palsy or another structural lesion. There are many things that can cause fixed constant diplopia; MS is one of these, but that diagnosis must be made in the appropriate context. The MRI of your brain sounds like a good idea.

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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