title: The ice test versus the rest test in myasthenia gravis.
abstract: OBJECTIVE
  To compare the ice test with the rest test in subjects with myasthenic and nonmyasthenic ptosis.
  
  
  METHODS
  Randomized, noninterventional trial.
  
  
  METHODS
  (1) Ten subjects with ptosis from previously undiagnosed myasthenia gravis. (2) Fifteen subjects with nonmyasthenic ptosis.
  
  
  METHODS
  Application of ice compared with rest.
  
  
  METHODS
  Improvement in eyelid elevation in millimeters after the application of a surgical glove filled with ice or cotton.
  
  
  RESULTS
  In myasthenic subjects, the median improvement of ptosis with the rest test was 2 mm and with the ice test was 4.5 mm. The difference between the rest and ice tests is significant (P: < 0.001). There was no improvement in ptosis in nonmyasthenic subjects with either test.
  
  
  CONCLUSIONS
  In myasthenic ptosis, improvement in eyelid elevation after the ice test is in part caused by rest. The ice test significantly improves ptosis more than rest alone does.
authors.affiliation: Neuro-ophthalmology Service, Wills Eye Hospital, Thomas Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Kubis
authors.forename: H V
authors.initials: HV
authors.lastname: Danesh-Meyer
authors.forename: P J
authors.initials: PJ
authors.lastname: Savino
authors.forename: R C
authors.initials: RC
authors.lastname: Sergott
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001510:Bed Rest; D001763:Blepharoptosis / Q000175:diagnosis* / Q000209:etiology; D003941:Diagnostic Techniques, Ophthalmological; D004311:Double-Blind Method; D005143:Eyelids / Q000473:pathology*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007053:Ice; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D007053:Ice