eMedicine Specialties > Ophthalmology > Ophthalmology for the General Practitioner

Myasthenia Gravis: Multimedia

Author: Shady Awwad, MD, Staff Physician, Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas
Coauthor(s): Riad Ma'luf, MD, Head, Division of Oculoplastics, Department of Ophthalmology, Clinical Assistant Professor, American University of Beirut Medical Center; Nicolas Hamush, MD, Consulting Staff, Department of Ophthalmology, Eye & Ear Hospital International, Naccache, Lebanon
Contributor Information and Disclosures

Updated: Jul 13, 2007

Multimedia

Increasing left ptosis developing upon sustained ...
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Media file 1: Increasing left ptosis developing upon sustained upward gaze in a patient with myasthenia gravis (A through F). Note the limited elevation of the left eye denoting superior rectus palsy (A). A initially, C after around 20 seconds, F after 1 minute.
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Increasing left ptosis developing upon sustained ...

Increasing left ptosis developing upon sustained upward gaze in a patient with myasthenia gravis (A through F). Note the limited elevation of the left eye denoting superior rectus palsy (A). A initially, C after around 20 seconds, F after 1 minute.

Cogan sign. The patient changes gaze from the dow...
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Media file 2: Cogan sign. The patient changes gaze from the downward position (A) to the primary position (B). Both lids are seen to overshoot in a twitch (B) before gaining their initial ptotic position (D). In this case, the Cogan sign is seen more obviously on the right, whereas the left lid is more ptotic.
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Cogan sign. The patient changes gaze from the dow...

Cogan sign. The patient changes gaze from the downward position (A) to the primary position (B). Both lids are seen to overshoot in a twitch (B) before gaining their initial ptotic position (D). In this case, the Cogan sign is seen more obviously on the right, whereas the left lid is more ptotic.

CT scan of chest/mediastinum showing a thymoma in...
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Media file 3: CT scan of chest/mediastinum showing a thymoma in a patient with myasthenia gravis.
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CT scan of chest/mediastinum showing a thymoma in...

CT scan of chest/mediastinum showing a thymoma in a patient with myasthenia gravis.

Repetitive nerve stimulation at a frequency of 2 ...
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Media file 4: Repetitive nerve stimulation at a frequency of 2 Hz showing an increasing decrement in the amplitude of the compound muscle action potential up to the fourth response (42% amplitude loss), after which it stabilizes.
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Repetitive nerve stimulation at a frequency of 2 ...

Repetitive nerve stimulation at a frequency of 2 Hz showing an increasing decrement in the amplitude of the compound muscle action potential up to the fourth response (42% amplitude loss), after which it stabilizes.

Single fiber electromyography showing the "jitter...
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Media file 5: Single fiber electromyography showing the "jitter" phenomenon (second action potential wave group).
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Single fiber electromyography showing the "jitter...

Single fiber electromyography showing the "jitter" phenomenon (second action potential wave group).

More on Myasthenia Gravis

Overview: Myasthenia Gravis
Differential Diagnoses & Workup: Myasthenia Gravis
Treatment & Medication: Myasthenia Gravis
Follow-up: Myasthenia Gravis
Multimedia: Myasthenia Gravis
References
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References

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  3. Van Stavern GP, Bhatt A, Haviland J, Black EH. A prospective study assessing the utility of Cogan's lid twitch sign in patients with isolated unilateral or bilateral ptosis. J Neurol Sci. May 15 2007;256(1-2):84-5. [Medline].

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Further Reading

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Keywords

MG, ocular myasthenia gravis, generalized myasthenia gravis, ocular MG, generalized MG, neuromuscular disorder

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Contributor Information and Disclosures

Author

Shady Awwad, MD, Staff Physician, Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas
Shady Awwad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, and American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Riad Ma'luf, MD, Head, Division of Oculoplastics, Department of Ophthalmology, Clinical Assistant Professor, American University of Beirut Medical Center
Disclosure: Nothing to disclose.

Nicolas Hamush, MD, Consulting Staff, Department of Ophthalmology, Eye & Ear Hospital International, Naccache, Lebanon
Nicolas Hamush, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Kilbourn Gordon III, MD, FACEP, Urgent Care Physician, Primary Medical, Huntington Walk-In and Greenwich Convenient Medical Center
Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

J James Rowsey, MD, Former Director of Corneal Services, St Luke's Cataract and Laser Institute, Florida
J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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