Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign

We report three cases of myasthenia gravis in whom the asymmetrical ptosis at presentation became more pronounced with the described bedside technique. Pronounced ptosis could be elicited by making the patient speak continuously for up to 2 minutes. Pauses for breathing and natural blinking were all...

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Autores principales: Vinny, Pulikottil W., Vishnu, Venugopalan Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064859/
https://www.ncbi.nlm.nih.gov/pubmed/33927532
http://dx.doi.org/10.1055/s-0040-1721559
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author Vinny, Pulikottil W.
Vishnu, Venugopalan Y.
author_facet Vinny, Pulikottil W.
Vishnu, Venugopalan Y.
author_sort Vinny, Pulikottil W.
collection PubMed
description We report three cases of myasthenia gravis in whom the asymmetrical ptosis at presentation became more pronounced with the described bedside technique. Pronounced ptosis could be elicited by making the patient speak continuously for up to 2 minutes. Pauses for breathing and natural blinking were allowed. The sign is best elicited in newly diagnosed and treatment-naive patients. The loss of compensation for ptosis by frontalis muscle due to speech-induced fatigue may be responsible for the observed effect. Patients’ symptoms abated on treatment with acetylcholine esterase inhibitors, steroids, and steroid-sparing agents.
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spelling pubmed-80648592021-04-28 Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign Vinny, Pulikottil W. Vishnu, Venugopalan Y. J Neurosci Rural Pract We report three cases of myasthenia gravis in whom the asymmetrical ptosis at presentation became more pronounced with the described bedside technique. Pronounced ptosis could be elicited by making the patient speak continuously for up to 2 minutes. Pauses for breathing and natural blinking were allowed. The sign is best elicited in newly diagnosed and treatment-naive patients. The loss of compensation for ptosis by frontalis muscle due to speech-induced fatigue may be responsible for the observed effect. Patients’ symptoms abated on treatment with acetylcholine esterase inhibitors, steroids, and steroid-sparing agents. Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-04 2021-01-13 /pmc/articles/PMC8064859/ /pubmed/33927532 http://dx.doi.org/10.1055/s-0040-1721559 Text en Association for Helping Neurosurgical Sick People. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Vinny, Pulikottil W.
Vishnu, Venugopalan Y.
Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title_full Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title_fullStr Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title_full_unstemmed Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title_short Pronounced Ptosis in Myasthenia Gravis—A New Bedside Clinical Sign
title_sort pronounced ptosis in myasthenia gravis—a new bedside clinical sign
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064859/
https://www.ncbi.nlm.nih.gov/pubmed/33927532
http://dx.doi.org/10.1055/s-0040-1721559
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