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Edrophonium infrared optokinetic nystagmography in the diagnosis of myasthenia gravis

Ocular Motor Neurophysiology Laboratory, Neurology Service, Miami Veterans Administration Hospital, and the Department of Neurology, University of Miami School of Medicine, Miami.

Horizontal optokinetic nystagmus was measured by an infrared eye movement recording technique before and after the administration of intravenous edrophonium chloride in 16 patients with proved myasthenia gravis. All the patients, even those without clinically apparent ophthalmoparesis, demonstrated an increased amplitude of optokinetic nystagmus after administration of the drug. None of 12 control patients, many with ophthalmoparesis, showed increased optokinetic nystagmographic amplitude. The superiority of infrared recording techniques to electro-oculography was discussed. Edrophonium infrared optokinetic nystagmography proved to be a sensitive and specific test of myasthenic weakness in extraocular muscles.

Presented in part at the twenty-sixth annual meeting of the American Academy of Neurology, San Francisco, April 26, 1974.

Received for publication September 3, 1974.

Dr. Daroff's address is Veterans Administration Hospital, Neurology Service (180), Ocular Motor Neurophysiology Laboratory, 1201 N.W. 16th Street, Miami, FL 33125.

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