learned some new stuff about MG (passing on the info)

AnnieB3 · 12-30-2010, 12:10 AM

Abby, Can you clarify what you mean by the "clenching" and the difference in the tests? Do you mean how we patients have to sustain a contraction of the muscle group they are testing?

Many doctors in Europe use magnets instead of needles. It still hurts though (yes, I've had it done both ways).

Is there a name for what was done?

Cogan's Lid Twitch

http://www.mrcophth.com/ptosis/myastheniagravis.html

http://www.ncbi.nlm.nih.gov/pubmed/17374543

Which is different than . . .

Enhanced Ptosis

http://www.medscape.com/viewarticle/410859_3

Quote:

Secondary Adaptive Features. As with other cause of ptosis, a lid droop may appear mild because of partial compensation: the true extent of ptosis can be revealed by covering the ptotic eye and observing the gradual increase in ptosis behind the cover over several minutes. Enhanced ptosis is a related sign[47] in which manual lifting of a ptotic eyelid -- thus eliminating the need for compensation -- causes the other apparently normal eye to develop ptosis, showing that the lid dysfunction is actually bilateral. This second-eye ptosis had been masked because the central compensatory increase in innervation directed at overcoming the more severe ptosis in the first eye is distributed to both eyes by Hering's law.[48] Manual elevation of one eyelid reduces the effort required to raise that eyelid and thus according to Hering's law less effort is also exerted by the contralateral levator muscle, and that eyelid becomes more ptotic. Enhancement of ptosis is not pathognomonic for myasthenia gravis, as it can be seen in patients with other causes of congenital and acquired ptosis, but in patients with appropriate history, it is highly suggestive of myasthenia gravis.

You had a very good doctor who knew the subtleties of MG. But the ones I saw knew of them too . . .

Annie

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