PURPOSE:
To compare the results of the
ice test with other
diagnostic tests for the
diagnosis of
myasthenia gravis in
patients with ptosis.
METHODS:
The
patients included in this study presented with suspicious myasthenic
blepharoptosis and visited the Department of
Ophthalmology, Guro
Hospital,
Korea University between March 2003 and February 2004 for
diagnosis. All
patients received "myasthenic ptosis workup" including the
ice test,
edrophonium test, RNS EMG, and anti-
acetylcholine receptor antibody (anti-AchR) titer test. The tests were compared for
specificity,
sensitivity, ease of performance, economic benefits and observed
complications.
RESULTS:
The
patients included six
men and nine
women with an average age of 36.9+/-2.4 yrs. Positive test results were obtained as follows
Ice test 80%,
edrophonium test 66.7%, RNS EMG 53.3%, and anti-AchR titer test 86.7%.
Adverse effects of
edrophonium test were encountered in two
patients who had
nausea,
vomiting, and
dizziness.
CONCLUSIONS:
The authors found that the
ice test was simpler, faster, more economic, and safer than the others for diagnosing
blepharoptosis caused by
myasthenia gravis. Considering its relative high
sensitivity and specificity, the
ice test should be the first
screening test given to
patients with suspicious myasthenic ptosis.