Q: What is the bedside ice test for myasthenia gravis?
Answer: Most Myasthenia patients, along with other symptoms of weakness, usually exhibit ptosis. While at the bedside, place an ice cube over the lids for 2 minutes. Cooling improves neuromuscular transmission. The resolution of ptosis with cooling is a positive test for myasthenia gravis, and it is reported to be very reliable in diagnosing ocular myasthenia.
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References:
1. Fakiri MO, Tavy DL, Hama-Amin AD, Wirtz PW. Accuracy of the ice test in the diagnosis of myasthenia gravis in patients with ptosis. Muscle Nerve. 2013 Dec;48(6):902-4. doi: 10.1002/mus.23857. Epub 2013 Sep 11. PMID: 23536427.
2. Chatzistefanou KI, Kouris T, Iliakis E, Piaditis G, Tagaris G, Katsikeris N, Kaltsas G, Apostolopoulos M. The ice pack test in the differential diagnosis of myasthenic diplopia. Ophthalmology. 2009 Nov;116(11):2236-43. doi: 10.1016/j.ophtha.2009.04.039. Epub 2009 Sep 10. PMID: 19744729.
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