PMID: 1206948Nov 1, 1975Paper

Diagnosis of myasthenic eye signs. Clinical signs and electronystagmographical findings of saccadic eye movements (author's transl)

Klinische Monatsblätter für Augenheilkunde
D Schmidt

Abstract

The clinical eye signs of 31 myasthenic patients are presented and those signs important for an early diagnosis are then discussed: lid symptoms caused by fatigue (Simpson-test), characteristic lid twitches as well as alternating asymmetrical eye muscle pareses. The importance of an investigation with the tangent scale in the course of which tensilon is injected is pointed out. False diagnosis and differential diagnostic signs are then considered (disseminated sclerosis, aneeurysm, encephalitis, pseudopulbarparalysis). - Our electronystagmographical investigations of saccadic eye movements showed hypometric, alternating saccades with occasional nystagmuslike jerks. After Tensilon injection hypermetric saccades (overshoots) were observed which depended on a disproportion of the supranuclear oculomotor centers and the eye muscles. The "muscleparetic" nystagmus is a pathologically increased endposition nystagmus. The hypometric nystagmuslike jerks during a saccadic eye movement are caused by insufficient phasic innervation.

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