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Unilateral Ptosis in a 72-Year-Old Male: Early Diagnosis of Myasthenia Gravis Using the Ice Pack Test
Paulo Conceição1, Renato Gonçalves2, Ana Reinas1
1Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, PRT.
Abstract:
Ptosis, or eyelid drooping, can be an early indicator of various neurological and muscular disorders, underscoring the need for accurate diagnosis to ensure proper management. Myasthenia gravis (MG), a neuromuscular disorder, may initially present with isolated ocular symptoms, often resulting in diagnostic delays. This report details the case of a 72-year-old male who presented to the emergency department with a two-week history of progressive unilateral ptosis. A neurological examination, paired with the "ice pack test" - a simple, noninvasive bedside technique - supported the diagnosis of MG. The test improves neuromuscular transmission through cold application, temporarily alleviating symptoms. Early diagnosis using accessible techniques like the ice pack test can facilitate timely intervention, enhancing patient outcomes. This case emphasizes the value of such methods in identifying MG in patients with isolated ocular manifestations.
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