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Ice-pack Test for Myasthenia Gravis - Likelihood Ratio (LR) +24 / -0.16 Ice pack's can be used to lessen the effect of acetylcholinesterase, effectively increasing ACh for depolarization and improving ptosis and fatigability. VA Joint Chiefs @BostonChiefs #Icepack #Test #Myasthenia #Gravis #physicalexam #neurology #diagnosis