We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Controversies in Neurology |

Treatment of Ocular Myasthenia Steroids Only When Compelled

Henry J. Kaminski, MD; Robert B. Daroff, MD
Arch Neurol. 2000;57(5):752-753. doi:10.1001/archneur.57.5.752.
Text Size: A A A
Published online


MYASTHENIA gravis (MG) preferentially involves the ocular muscles.1 Ocular myasthenia manifests as weakness of the levator palpebrae superioris leading to ptosis, or the extraocular muscles producing diplopia. The precise reasons for this predilection are poorly understood.2,3 As with all therapies for MG, there are few well-controlled studies of treatments of ocular myasthenia.4 Immunosuppressive therapies, in particular the corticosteroid prednisone, are the mainstay of treatment for generalized MG that compromises an individual's daily activities. Prednisone is also commonly used for ocular myasthenia. However, 4 factors should be considered prior to the use of steroids for patients with MG isolated to the ocular muscles: (1) Could the patient's symptoms improve with safer forms of therapy? (2) Will steroid treatment lead to resolution of symptoms? (3) Does the severity of the symptoms warrant the risk of steroid adverse effects? (4) Do steroids reduce the chance of generalization? We consider each of these questions and reach the conclusion that only the occasional case of ocular myasthenia should be treated with steroids.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

20 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
[MYASTHENIAS: THYMECTOMY AND SPIRONOLACTONES]. Rev Otoneuroophtalmol ;36():169-74.
[Immunosuppressive therapy of myasthenias]. Med Welt 1973;24(23):955-63.