Currently, there is no universally accepted standard treatment for ocular myasthenia gravis (OMG) in children. We aimed to investigate the possible proper regimens and timing of treatment for pediatric OMG cases based on the clinical manifestations: OMG with ptosis only and OMG with other features. One hundred and forty two OMG cases attended at the Department of Pediatrics, Xiangya Hospital, Central South University, from 2010 to 2019 were included, and information from medical records was reviewed and recorded. Comparisons of clinical characteristics between patients with OMG with ptosis only and patients with OMG with other features as well as between patients treated with glucocorticoid (GC) within or after six months from disease onset were performed. OMG with other features constituted about 54.9% of the cases, and 66.2% of the patients achieved optimal outcome. Patients with OMG with ptosis only responded to pyridostigmine alone more than patients with OMG with other features who required several therapies ( < 0.001). Patients with OMG with ptosis only had a larger proportion of optimal outcome than the patients with OMG with other features ( = 0.002), and the difference remained significant even when the individual outcome groups were compared ( < 0.001). Patients who received GC within six months had a greater proportion of optimal outcome than those who received it after six months ( < 0.001). Although OMG with other features is a more common subtype of OMG, it is also more severe than OMG with ptosis only. An earlier addition of GC leads to optimal outcome.

中文翻译：

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小儿眼部重症肌无力：单中心经验

目前，儿童眼肌无力（OMG）尚无普遍接受的标准治疗方法。我们的目的是根据儿童 OMG 病例的临床表现（仅伴有上睑下垂的 OMG 和具有其他特征的 OMG）探讨可能的适当治疗方案和治疗时机。纳入2010年至2019年在中南大学湘雅医院儿科就诊的142例OMG病例，并对病历信息进行审查和记录。对仅伴有上睑下垂的 OMG 患者与具有其他特征的 OMG 患者之间以及在发病后 6 个月内或之后接受糖皮质激素 (GC) 治疗的患者之间的临床特征进行了比较。具有其他特征的 OMG 约占病例的 54.9%，66.2% 的患者取得了最佳结果。患有上睑下垂的 OMG 患者仅对单独吡斯的明的反应高于需要多种治疗的具有其他特征的 OMG 患者 (< 0.001)。仅伴有上睑下垂的 OMG 患者比具有其他特征的 OMG 患者获得最佳结果的比例更大 ( = 0.002)，并且即使比较各个结果组，差异仍然显着 ( < 0.001)。六个月内接受 GC 的患者比六个月后接受 GC 的患者获得最佳结果的比例更高 (< 0.001)。尽管具有其他特征的 OMG 是 OMG 更常见的亚型，但它也比仅伴有上睑下垂的 OMG 更严重。较早添加 GC 可带来最佳结果。