Reader Response: Comparison of Ice Pack Test and Single-Fiber EMG Diagnostic Accuracy in Patients Referred for Myasthenic Ptosis

Giannoccaro et al.1 reported their findings on the sensitivity and specificity of the ice pack test and single-fiber electromyography (SF-EMG) in the diagnosis of ocular myasthenia gravis. It is interesting—and perhaps humbling—that such a straightforward test as cooling muscle with ice has very similar diagnostic accuracy compared with a technically complex and sophisticated test as SF-EMG in patients presenting with eyelid ptosis. These findings are largely in line with previous research evaluating the positive and negative predictive values of the ice pack test in ocular myasthenia gravis.2-5

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