Risk for generalization in ocular onset myasthenia gravis: experience from a neuro-ophthalmology clinic

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dc.contributor.authorKısabay A.
dc.contributor.authorÖzdemir H.N.
dc.contributor.authorGökçay F.
dc.contributor.authorÇelebisoy N.
dc.date.accessioned2024-07-22T08:04:46Z
dc.date.available2024-07-22T08:04:46Z
dc.date.issued2022
dc.description.abstractConversion to generalized myasthenia gravis (GMG) within the first 2 years has been reported in 18–85% of patients with ocular myasthenia gravis (OMG). The aim of the study was to investigate the risk factors for generalization in patients with OMG admitted to a neuro-ophthalmology clinic and to determine if there were differences between patients with GMG with predominant bulbar (GMG-B) or extremity muscle (GMG-E) involvement according to the 6th and 24th-month Myasthenia Gravis Foundation of America classification ranks. Patients with OMG who were followed-up for at least 24 months were retrospectively analyzed. Demographic, clinical, laboratory features and treatment strategies that can be associated with generalization and time to generalization were evaluated. Of the 139 patients with OMG, 54 (39%) showed generalization with a mean time of 10.3 (range 2–24) months. GMG-B and GMG-E were diagnosed in 31 (22.3%) and 23 patients (16.5%), respectively. Seropositivity for acetylcholine receptor and muscle-specific tyrosine kinase antibodies, abnormal single-fiber electromyography (SFEMG), and the presence of thymic abnormalities (thymoma and hyperplasia) were factors associated with generalization on multivariate analysis without a significant difference between the GMG-B and GMG-E groups. In addition, an abnormal repetitive nerve stimulation test was related to a shortened time to generalization. Bilateral ptosis at onset was found as a risk factor for generalization. In a neuro-ophthalmology clinic, bilateral ptosis as an initial feature of OMG must be approached cautiously because it may be the first sign of impending GMG. © 2021, Belgian Neurological Society.
dc.identifier.DOI-ID10.1007/s13760-020-01582-1
dc.identifier.issn03009009
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/12838
dc.language.isoEnglish
dc.publisherSpringer Science and Business Media Deutschland GmbH
dc.subjectAntibodies
dc.subjectElectromyography
dc.subjectHumans
dc.subjectMyasthenia Gravis
dc.subjectOphthalmology
dc.subjectRetrospective Studies
dc.subjectazathioprine
dc.subjectcholinergic receptor
dc.subjectprednisone
dc.subjectprotein tyrosine kinase
dc.subjectpyridostigmine
dc.subjectsteroid
dc.subjectantibody
dc.subjectadult
dc.subjectaged
dc.subjectantibody titer
dc.subjectArticle
dc.subjectchi square test
dc.subjectclinical laboratory
dc.subjectcomputer assisted tomography
dc.subjectcontrolled study
dc.subjectdemography
dc.subjectdiagnostic test
dc.subjectdiplopia
dc.subjectdrug dose increase
dc.subjectdrug dose reduction
dc.subjectdysphagia
dc.subjectelectromyography
dc.subjectelectrophysiological assay
dc.subjectfemale
dc.subjectfollow up
dc.subjecthuman
dc.subjecthyperplasia
dc.subjectice pack test
dc.subjectKaplan Meier method
dc.subjectlog rank test
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmastication
dc.subjectmultivariate analysis
dc.subjectmuscle weakness
dc.subjectmyasthenia gravis
dc.subjectnerve stimulation
dc.subjectneuroophthalmology
dc.subjectnuclear magnetic resonance imaging
dc.subjectobservational study
dc.subjectprospective study
dc.subjectprovocation test
dc.subjectptosis (eyelid)
dc.subjectradioimmunoassay
dc.subjectrespiratory failure
dc.subjectretrospective study
dc.subjectrisk assessment
dc.subjectrisk factor
dc.subjectsingle fiber electromyography
dc.subjectspeech disorder
dc.subjectthymoma
dc.subjectthymus hyperplasia
dc.subjectvery elderly
dc.subjectmyasthenia gravis
dc.subjectophthalmology
dc.titleRisk for generalization in ocular onset myasthenia gravis: experience from a neuro-ophthalmology clinic
dc.typeArticle

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