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At presentation, more than half of patients with myasthenia gravis (MG) harbor the form of the condition known as ocular MG (OMG), characterized by double vision, ptosis, or both. When ptosis is present, the diagnosis is suggested by the Cogan lid twitch, fatigability of the eyelid with sustained upgaze, and recovery with the icepack test or rest. The examination, however, may not always demonstrate these findings.1 In many patients with OMG, particularly those without ptosis, the diagnosis can be elusive.
- © 2016 American Academy of Neurology
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