PDF(Pubmed)
Abstract：
The current pharmaceutical management of myasthenia gravis (MG) is widely accepted to be pyridostigmine and prednisone, both known to cause adverse effects and incur significant costs. This treatment may be particularly burdensome for patients primarily complaining of localized ocular MG, and little is known about the management of MG ptosis with topical medications. Oxymetazoline hydrochloride 0.1% ophthalmic solution has recently been approved by the FDA for the treatment of ptosis, but there have been limited studies in MG ptosis and no report to date of symptomatic improvement with the intranasal formulation. This case report discusses a 71-year-old female whose newly diagnosed MG ptosis resolved after three days of intranasal oxymetazoline hydrochloride 0.05%, followed by three days of intranasal flunisolide. Our patient\'s rapid resolution of symptoms, along with the favorable side effect profile and over-the-counter availability, highlights the promising indication for the use of intranasal oxymetazoline and flunisolide as potential alternatives or adjuncts in MG management. Further research in larger cohorts is necessary to confirm the efficacy of these nasal sprays in treating MG ptosis.
摘要：
目前重症肌无力(MG)的药物管理被广泛接受为吡啶斯的明和泼尼松,已知会造成不利影响并产生巨大成本。对于主要抱怨局部眼部MG的患者，这种治疗可能特别麻烦。关于局部用药对MG上睑下垂的治疗知之甚少。0.1%盐酸羟甲唑啉滴眼液最近被FDA批准用于治疗上睑下垂,但对MG上睑下垂的研究有限,迄今尚无关于鼻内给药改善症状的报道.该病例报告讨论了一名71岁的女性，其新诊断为MG下垂在鼻内服用0.05％盐酸羟甲唑啉三天后消退，然后鼻内注射氟尼缩松三天。我们的病人迅速解决的症状，随着有利的副作用和非处方可用性，强调了在MG管理中使用鼻内羟甲唑啉和氟尼缩松作为潜在替代品或辅助剂的有希望的适应症。需要在更大的队列中进行进一步的研究，以确认这些鼻喷雾剂治疗MG下垂的功效。
