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- CLINICA NEUROL, 46: 266－269, 2006
- Vol.46 No.4 contents
Case Report
Severe Graves' ophthalmopathy accompanied by myasthenia gravis
Kengo Maeda, M.D.1), Shinji Kume, M.D.2), Yoshihiko Nishio, M.D.3), Shiro Maeda, M.D.2), Yasuhiro Nishida, M.D.4), Mikio Suzuki, M.D.5), Takahiro Nakaguchi, M.D.6), Toru Kawabata, M.D.1)7), Osamu Hashimoto, M.D.7), Takashi Hisanaga, M.D.8), Atsunori Kashiwagi, M.D.3) and Hitoshi Yasuda, M.D.1)
Divisions of 1)Neurology, 2)Nephrology, and 3)Metabolism and Endocrinology, Department of Medicine,
Departments of 4)Ophthalmology, 5)Otolaryngology-Head and Neck Surgery, and
6)Radiology, Shiga University of Medical Science
7)Department of Neurology, Nagahama Red Cross Hospital
8)Department of Neurology, Shigaraki National Hospital
We report a 53-year-old woman with severe Graves' ophthalmopathy accompanied by uncontrolled myasthenia gravis. She presented remarkable exophthalmos, chemosis, and restriction of eye movement. Despite plasma exchange, steroid pulse therapy, local injection of steroid, and irradiation, ocular symptoms did not ameliorate. Since optic neuropathy was seen, orbital decompression surgery was performed in the left eye. Bilateral chemosis was improved after the surgery. Five years after surgery, there was no ocular palsy in the operated left eye, but in the contralateral eye. For the good prognosis of the eye movement, orbital decompression might be recommended in the severe Graves' ophthalmopathy accompanied by the optic neuropathy and/or ophthalmoplegia with proptosis.
(CLINICA NEUROL, 46: 266－269, 2006)
key words: Graves' ophthalmopathy, myasthenia gravis, surgical treatment, plasma exchange
(Received: 6-Jun-05)
