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diagnosis of ocular myasthenia gravis Bienfang's test is a clinical test used in the diagnosis of ocular myasthenia gravis . It is used in conjunction with other examination techniques such as Cogan's lid twitch test [ 1 ] or enhancement of blepharoptosis from prolonged upward gaze.
The symptoms of ocular MG can also be addressed by non-medicinal means. Ptosis can be corrected with placement of crutches on eyeglasses and with ptosis tape to elevate eyelid droop. Diplopia can be addressed by occlusion with eye patching, frosted lens, occluding contact lens, or by simply placing opaque tape over a portion of eyeglasses.
Thus, this test can be used to clinically differentiate between ocular myasthenia gravis and normal individuals. Since myasthenia gravis affects all skeletal muscles, eyelid drooping is often bilateral. It is sometimes done in conjunction with tensilon test, where edrophonium is injected to look for reversibility of eyelid drooping. In ...
What causes myasthenia gravis? Because MG is an autoimmune disorder , it's caused by dysfunction within the immune system − though the source of the dysfunction is not entirely known or understood.
Myasthenia gravis affects 50 to 200 people per million. [3] [4] It is newly diagnosed in 3 to 30 people per million each year. [13] Diagnosis has become more common due to increased awareness. [13] Myasthenia gravis most commonly occurs in women under the age of 40 and in men over the age of 60. [1] [5] [14] It is uncommon in children. [1]
MG may present as muscle weakness in different areas of the body: a) ocular MG is skeletal muscle weakness in the eyes that causes ptosis (i.e., eyelid drooping), weak eyelid closure, strabismus (i.e., one eye turned in a direction different from the other eye), diplopia (i.e., double vision), and/or complex ophthalmoplegias (e.g., weakness or ...
The eye that is suppressing is the eye which the corresponding line is not seen. Two lines: If the patient sees two lines, this means that there is no suppression of either eye. Disappearing line: The patient may report that they see one line, then the lines switch and they can only see the other line. This is the case in an alternating ...
Also specific to myasthenia gravis is the fact that coldness inhibits the activity of cholinesterase, which makes it possible to differentiate this type of ptosis by applying ice onto the eyelids. Patients with myasthenic ptosis are likely to experience a variation in the drooping of the eyelid at different hours of the day.