Myasthenia gravis (MG): miscellaneous tests

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Myasthenia gravis (MG): miscellaneous tests. This is done when the Edrophonium test is contraindicated. Fully referenced neurology checklist.

Ice pack test

  • This is done when the Edrophonium test is contraindicated
  • An ice pack is placed over the eye for 2-5 minutes
  • This may lead to improvement of ptosis
  • The test is falsely positive with botulism
  • The diagnosis of MG should not rely on this test

Blood tests

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Biopsy for thymoma

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Video oculography (VOG)-based eye tracking

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Emerging MG biomarkers

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References

  1. Thanvi BR, Lo TCN. Update on myasthenia gravis. Postgrad Med J 2004; 80:690–700.
  2. Sethi KD, Rivner MH, Swift TR. Ice pack test for myasthenia gravis. Neurology 1987; 37:1383–1385.
  3. Cosentino G, Alfonsi E, Lonati D, Locatelli CA, Valentino F, Brighini F. Positive ice pack test in a case of food-borne botulism: a clinical note. J Neurol 2012; 259:2486-2587.
  4. Larner AJ, Thomas DJ. Can myasthenia gravis be diagnosed with the ‘ice pack test’? A cautionary note. Postgrad Med J 2000; 76:162-163.
  5. Sussman J, Farrugia ME, Maddison P, Hill M, Leite MI, Hilton-Jones D. Myasthenia gravis: Association of British Neurologists' management guidelines. Pract Neurol 2015; 15:199-206.
  6. And 11 more. Subscribe to see the full list

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