Exam

Ice Pack Test

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Ice Pack Test

  • Indications
  1. Ptosis evaluation in suspected Myasthenia Gravis
  • Contraindications
  1. Not useful in extraocular Muscle Weakness evaluation
  • Mechanism
  1. Neuromuscular transmission improves at cooler Temperatures
  • Preparation
  1. Fill small bag (or surgical glove) with ice
  • Technique
  1. Evaluate Ptosis before applying ice
  2. Place filled ice bag over a closed lid for 2 minutes
  3. Remove ice after 2 minutes
  4. Evaluate Ptosis immediately after removing ice
  • Interpretation
  1. Ptosis improves in 80% of Myasthenia Gravis with topical ice
  2. Ptosis does not tend to improve in the absence of Myasthenia Gravis