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January 1, 1982

Ocular MyastheniaMultiple Recurrences and Spontaneous Remissions

JAMA. 1982;247(1):62. doi:10.1001/jama.1982.03320260046030

OCULAR myasthenia is a wellknown, localized form of myasthenia gravis frequently limited to the extraocular muscles. It occurs in 20% to 25% of adult patients with this disorder.1,2 A patient with ocular myasthenia in whom multiple brief recurrences were each followed by rapid spontaneous remission lasting several years is the subject of this report.

Report of a Case  A 54-year-old man noted gradual drooping of the right upper eyelid in July 1980. He noticed that when he looked up, he had vertical diplopia that disappeared when he closed either eye. One day after the onset of the ptosis, the patient had a tensilon test, with negative results. The ophthalmologist noted fasciculations of the eyelids following injection of tensilon, but no change in the moderate ptosis.Fifteen years previously, the patient had had an episode of horizontal diplopia that also disappeared with closure of either eye. Eight years previously, he