Two Cases with Positive Ice Tests Mimicking Ocular Myasthenia Gravis.
10.3341/jkos.2015.56.2.309
- Author:
Eoi Jong SEO
1
;
Aram PARK
;
Seung Ah CHUNG
Author Information
1. Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. mingming8@naver.com
- Publication Type:Case Report
- Keywords:
Anti-nuclear antibody;
Ice test;
Myasthenia gravis;
Oculomotor nerve palsy
- MeSH:
Adult;
Aneurysm;
Angiography;
Arteries;
Blepharoptosis;
Brain;
Diagnosis;
Diagnosis, Differential;
Diplopia;
Female;
Humans;
Ice*;
Mass Screening;
Myasthenia Gravis*;
Ocular Motility Disorders;
Oculomotor Nerve Diseases
- From:Journal of the Korean Ophthalmological Society
2015;56(2):309-315
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report two patients with positive ice tests who had diplopia and blepharoptosis caused by something other than ocular myasthenia gravis. CASE SUMMARY: A 35-year-old female presented with a one-week history of inability to adduct the left eye and left blepharoptosis. Although the ice test was positive, serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Brain angiography showed an aneurysm of the left posterior communicating artery, leading to the diagnosis of left pupil-sparing oculomotor nerve palsy. A 25-year-old female presented with an 8-month history of intermittent horizontal diplopia and blepharoptosis in the right eye. The ice test was positive, however serum anti-acetylcholine receptor binding antibody and the repetitive nerve stimulation test were negative. Anti-nuclear antibody was positive (titer 1:160). CONCLUSIONS: The ice test is a useful screening test for myasthenia gravis. However, a series of differential diagnoses including blepharoptosis and ocular motility disorder should be considered because these conditions also show a positive result in the ice test.
