Tuesday, January 29, 2008

Differential diagnosis of ocular myasthenia

1.Any IV,VI, and partial IIInn palsies
2. Graves opthalmopathy (however, should not see ptosis, and may see lid retraction)
3. CPEO Chronic progressive external opthalmoplegia(get symmetric ptosis and EOM weakness, but unlike myasthenia, SACCADES ARE SLOW in CPEO
4. Oculopharyngeal dystrophy-- chronic, slowly progressive, family history present, bulbar mm are involved.
5. Glycogenosis type II -- ptosis is presenting feature often (Neurology 69 : 116 2007) with skeletal muscle weakness later. Muscle biopsy may be needed to show increased glycogen content and acid maltase deficiency,
6. Autoimmune encephalitis with diplopia: http://dementianotes.blogspot.com/2008/06/vgkc-autoantibodies-mimicking-cjd.html

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