I keep a little, ever-expanding note on my phone where I jot down little morsels of goodness that I pick up while listening to or reading one of the many excellent sites/podcasts in the useful resource section.
I’ll try and transfer them here for your enlightenment.
From the August EMJ a little tip on diagnosing myasthenia gravis:
- apply ice pack to closed eyes when ptosis present. If ptosis improves then likely myasthenia
- ice thought to reduce activity in acetylcholinesterase
- they quote a sensitivity of 80% which Is actually similar to the tensilon test.
- not so good when only limb symptoms present
this isn’t all that useful in reality as someone with a gradual onset of bilateral cranial nerve signs in an odd pattern (especially tongue and eyes signs) has myasthenia on that alone… Still it’s a nice trick.