The ice test versus the rest test in myasthenia gravis.

Abstract

To compare the ice test with the rest test in subjects with myasthenic and nonmyasthenic ptosis. Randomized, noninterventional trial. (1) Ten subjects with ptosis from previously undiagnosed myasthenia gravis. (2) Fifteen subjects with nonmyasthenic ptosis. Application of ice compared with rest. Improvement in eyelid elevation in millimeters after the application of a surgical glove filled with ice or cotton. In myasthenic subjects, the median improvement of ptosis with the rest test was 2 mm and with the ice test was 4.5 mm. The difference between the rest and ice tests is significant (P: < 0.001). There was no improvement in ptosis in nonmyasthenic subjects with either test. In myasthenic ptosis, improvement in eyelid elevation after the ice test is in part caused by rest. The ice test significantly improves ptosis more than rest alone does.