Pseudo-Internuclear Ophthalmoplegia as a Sign of Overlapping Myasthenia Gravis in a Patient with 'Intractable' Hypothyroidism

DOI Web Site 参考文献12件
  • Yamazaki Yuu
    Department of Clinical Neuroscience and Therapeutics, Hiroshima University
  • Sugiura Tomohito
    Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • Kurokawa Katsumi
    Department of Neurology, Kawasaki Medical School

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We describe a 52-year-old man with a history of increasing fatigability and gait disturbances that were first attributed to hypothyroidism. On examination, he had bilateral pseudo-internuclear ophthalmoplegia with weakness of adduction and abducting nystagmus. Convergence was also impaired and he showed proximal weakness of the limb. Intravenous edrophonium almost completely abolished the nystagmus and adducting muscle weakness, and improved the strength of proximal muscles groups. The clinical response to the administration of edrophonium, the presence of AChR binding antibodes and the repetitive nerve stimulation test findings indicated that the patient had pseudo-internuclear ophthalmoplegia as a manifestation of generalized myasthenia gravis. Whereas hypothyroidism was effectively controlled with levothyroxine, his subsequent response to thymectomy, prednisolone and cholinesterase inhibitors confirmed the diagnosis of generalized myasthenia gravis.<br>

収録刊行物

  • Internal Medicine

    Internal Medicine 49 (1), 69-72, 2010

    一般社団法人 日本内科学会

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