Dr. RISHIKESH MAYEE

Abstract

Ocular myasthenia constitutes >35% of the cases in children.The present study is a prospective analysis over 1 year aimed at evaluating the outcomes of the medical treatment in childhood ocular myasthenia. 8 cases aged 6-15 years included. All had bilateral ptosis, diurnal variation in 5 cases, Cogan’s lid-twitch in 3 cases, ophthalmoplegia in 6 cases, positive ice-pack test in all cases, positive neostigmine test in 7 cases. All cases were managed with oral pyridostigmine and steroids over first 3 months and tapered over next 3 months.Patients were followed up regularly over 2 years. Improvement in ptosis, ocular movement and binocular diplopia noted. All cases showed some remission after commencement of treatment in 1 month. 4 cases showed complete remission in first month, while other 4 showed over next 2 months, 2 cases developed recurrence, no case of generalised myasthenia. Thus early medical treatment helps in remission, avoids recurrence and generalized myasthenia.