Overview and Epidemiology of Ocular Myasthenia Gravis
摘要
More than 300 years ago, human understanding of myasthenia gravis (MG) was very limited. It was not until 1672 that Thomas Willis [1] first detailed the manifestations of MG patients, including bulbar and truncal muscle weakness and the phenomenon of morning light and evening heavy, these symptoms are collectively referred to as “pseudoparalysis.” Willis proposed that this weakness might be caused by fluctuations in the content of some “explosive medium” substance in the blood. Entering the nineteenth century, Erb [2] provided a more comprehensive description of MG, including symptoms such as bilateral ptosis and diplopia, and it was noted that some cases had temporary relief. In 1952, Dr. Goldflam [3] from Warsaw, Poland, analyzed the symptoms and prognosis of MG in detail and proposed differentiation from bulbar palsy and hysteria. He pointed out that MG patients have normal swallowing reflexes, no muscle atrophy and tremors, normal sphincter function, normal reflexes; but fatigue appears after repeated stimulation. Goldflam’s paper is considered the “most important discourse in the history of MG understanding.” Therefore, MG was once named Erb-Goldflam symptom-complex. In 1895, German physician Friedrich Jolly [4] proposed the term “myasthenia gravis” at a meeting of the Berlin Society, derived from Greek and Latin, meaning severe muscle weakness. Jolly also observed the phenomenon of gradually weakening muscle responsiveness in electrotherapy, which later developed into an important diagnostic method for myasthenia gravis—repetitive nerve stimulation (RNS) examination.