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August 21, 1943


JAMA. 1943;122(17):1180-1181. doi:10.1001/jama.1943.72840340001009

A recent report by Moore1 has directed attention to the fact that occasional cases of myasthenia gravis exhibit no symptoms or signs other than those referable to the ocular apparatus. Coincidentally, he raises considerable speculation as to the frequency with which this monosymptomatic form of myasthenia is erroneously diagnosed as neurosyphilis, organic oculomotor palsy or some similar neurologic condition. Although ocular signs and symptoms are numbered among the common clinical features of myasthenia, their correct etiologic basis is often overlooked until other unmistakable and more widespread concomitants have made their appearance. Two cases illustrative of this condition, i. e. monocular myasthenia gravis, are described. In 1 of these neurosyphilis had been suspected as the etiologic factor. In the other, in which diplopia was complained of, the clinical picture, in addition to ptosis, suggested the diagnosis of oculomotor nerve paralysis. Moore also cites 1 case seen several years earlier in