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October 10, 2011
The ice pack test is a quick, inexpensive, and simple bedside test to aid in the diagnosis of myasthenia gravis. For a patient with ptosis and diplopia, the examiner applies a covered ice pack to the eyes for 2-5 minutes and if positive, there is improvement of either one or both symptoms. The proposed mechanism is that cooling of the skeletal muscle fibers inhibits the activity of acetylcholinesterases. This test has a reported sensitivity of 76.9% and specificity of 98.3%.
Submitted by: Dimitrios A. Nacopoulos, MD and Seby John, MD, Neurology Residents, Cleveland Clinic. Cleveland, Ohio
Disclosures:Drs. Nacopoulos & Seby report no disclosures.
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