Tasty Morsels of EM 018

8 Sep

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.

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