Neurology Book

Approach

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Ice Pack Test

Aka: Ice Pack Test
  1. See Also
    1. Myasthenia Gravis
    2. Tensilon Test (Edrophonium Test)
  2. Indications
    1. Ptosis evaluation in suspected Myasthenia Gravis
  3. Contraindications
    1. Not useful in extraocular Muscle Weakness evaluation
  4. Mechanism
    1. Neuromuscular transmission improves at cooler Temperatures
  5. Preparation
    1. Fill small bag (or surgical glove) with ice
  6. Technique
    1. Evaluate Ptosis before applying ice
    2. Place filled ice bag over a closed lid for 2 minutes
    3. Remove ice after 2 minutes
    4. Evaluate Ptosis immediately after removing ice
  7. Interpretation
    1. Ptosis improves in 80% of Myasthenia Gravis with topical ice
    2. Ptosis does not tend to improve in the absence of Myasthenia Gravis
  8. References
    1. Sethi (1987) Neurology 37(8):1383-5 [PubMed]

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