Diagnosis of Myasthenia Gravis - Physical Exam Maneuvers • Sustained lateral gaze for seconds to elicit fatigable diplopia • Sustained upgaze for seconds to elicit fatigable ptosis • Lifting the ptotic eyelid will cause the other eyelid to droop (Hering's law) • Testing eyelid closure strength • Asking patient to make high-pitched sounds to elicit hoarseness due to laryngeal weakness • Assessing for neck flexor weakness as proxy of respiratory muscle strength • Asking the patient to count as high as possible on one breath to estimate vital capacity • Testing for fatigable limb weakness with repetition or sustained posture - BWH Medicine Residency @BrighamMedRes #Myasthenia #Gravis #PhysicalExam #Maneuvers #Diagnosis #neurology
