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During the past 50 years, I have diagnosed and managed hundreds of patients with myasthenia gravis (MG) and large numbers with ptosis due to other conditions (Drachman DB et al. Johns Hopkins Neurology: Half a Century of Innovation. Johns Hopkins Press 2019; 26). I confess that I have never carried out an ice test. However, many MG patients referred to me by ophthalmologists have had ice tests. A group from Italy has now provided data evaluating the results of ice tests and comparing them with results of single-fiber electromyography (SFEMG) in 155 patients with ptosis.
The sensitivity of the ice test in diagnosing MG was 86%, compared with the slightly but not significantly higher 94% for SFEMG. The specificity of both was 79%. The final di…