How is ptosis diagnosed in patients with myasthenia gravis?

Updated: Sep 20, 2018
  • Author: William D Goldenberg, MD; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Answer

Cooling may improve neuromuscular transmission. In a patient with myasthenia gravis who has ptosis, placing ice over an eyelid will lead to cooling of the lid, which leads to improvement of the ptosis.

Lightly placing ice that is in a surgical glove or that is wrapped in a towel over the eyelid will cool it within 2 minutes. [2] A positive test is clear resolution of the ptosis. [10, 3]

This test has a pooled sensitivity and specificity of 82% and 96%, respectively. However, the literature generally overestimates the test’s usefulness, since most of the studies were case-control designs. [11]


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