Myasthenia gravis physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Myasthenia can be a difficult diagnosis, as the symptoms can be subtle and hard to distinguish from both normal variants and other neurological disorders.[1] A thorough physical examination can reveal easy fatiguability, with the weakness improving after rest and worsening again on repeat of the exertion testing. Applying ice to weak muscle groups characteristically leads to improvement in strength of those muscles.
Physical Examination
Muscle fatigability can be tested for many muscles. A thorough examination demonstrates easy fatigability during following movements:
- Looking upward and sidewards for 30 seconds: ptosis and diplopia.
- Looking at the feet while lying on the back for 60 seconds
- Keeping the arms stretched forward for 60 seconds
- 10 deep knee bends
- Walking 30 steps on both the toes and the heels
- 5 situps, lying down and sitting up completely