Ocular myasthenia gravis (MG)

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Ocular myasthenia gravis (MG). This is often partial. It is unilateral or bilateral. Fully referenced neurology checklist.

Ptosis

  • This is often partial
  • It is unilateral or bilateral
  • Eyelids fatigue with sustained up-gaze for ≥ 30 seconds
  • It improves after sleep: the sleep test
  • It improves with the ice pack test
  • It may improve with forceful eye closure

Enhanced ptosis

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Ophthalmoplegia

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Cogan’s lid twitch

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Other signs

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Treatment options

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References

  1. Sieb JP. Myasthenia gravis: an update for the clinician. Clin Exp Immunol 2014; 175:408-418.
  2. Thanvi BR, Lo TCN. Update on myasthenia gravis. Postgrad Med J 2004; 80:690–700.
  3. Jayam Trouth A, Dabi A, Solieman N, Kurukumbi M, Kalyanam J. Myasthenia gravis: a review. Autoimmune Dis 2012; 2012:874680.
  4. Zouvelou V, Daponte A. Teaching Video NeuroImage: Resolution of ptosis after forceful eye closure: bedside diagnosis of myasthenia gravis. Neurology 2021; 97:e649-e650.
  5. Gorelick PB, Rosenberg M, Pagano RJ. Enhanced ptosis in myasthenia gravis. Arch Neurol 1981; 38:531.
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