Myasthenia Gravis Ptosis Ice Test

B immediately after 2 minute application of ice ptosis in the left eye significantly improved with a fissure change of 2 5 mm.

Myasthenia gravis ptosis ice test. Diagnostic tests to establish the diagnosis of mg as the cause of ptosis include serum acetylcholine receptor antibody levels electromyography emg the tensilon test the sleep test the rest test and the ice test. 1 2 3 4 5 6 7 8. Myasthenia gravis mg is an autoimmune disorder that often is seen with ptosis. This transient improvement in ptosis is due to the cold decreasing the acetylcholinesterase break down of acetylcholine at the neuromuscular junction.

The ice pack test is positive in most patients who have ptosis caused by myasthenia gravis sensitivity is 77 100 and specificity is 88 100 implying a 0 12 chance that the result will also be positive in patients with non myasthenic ptosis. A patient with bilateral ptosis in myasthenia gravis showing inconsistent results of the ice test performed on separate days in the right eye. Establishing the diagnosis of isolated ocular myasthenia is sometimes difficult. It is highly sensitive and specific for mg.

To compare the ice test with tensilon test in sub jects with myasthenic and nonmyasthenic. An ice pack is applied to the affected upper eyelid for 2 5 minutes. This is also a simple diagnostic test that can be done in the clinic. A patient with symptoms of a myasthenic crisis was successfully diagnosed with myasthenia gravis mg using an approach called the ice pack test a case study reports.

Except for this finding further investigations and treatment provided no other evidence of mg in their case making diagnosis uncertain. Ice pack test in myasthenia gravis almeida et al. Myasthenia gravis was suspected and an ice pack test was performed with an instant cold pack over the left. A positive test is the improvement of ptosis by 2mm or more.

Prior to the test the patient demonstrated a marked ptosis more prominent on the right figure 1a. Myasthenia gravis often presents with ocular features most usually diplopia and ptosis. The ice test is useful for ptosis. 40 of patients have extra ocular muscle involvement at onset and the disease remains confined to the eyes in 16 of patients.

Test on eye movements. An international journal of medicine. This involved holding ice packs over the patient s closed eyes for 1 min and monitoring for resolution of ptosis. A asymmetric ptosis was present in both eyes prior to the ice test.

The study ice pack test an useful bedside test to diagnose myasthenia gravis was published in qjm. Symptomatic response to acetylcholinesterase medication may be equivocal and acetylcholine receptor achr auto antibodies may be absent in up to 30 of those with symptoms restricted.