Overview
Patients with myaesthenic syndromes exhibit muscle fatigability, or the inability to maintain contraction of muscles over time.
Signs of Myaesthenia Gravis
Skeletal Muscle Fatiguability
- Simpson's test - ptosis on sustained upward gaze
- Peek sign - inability to maintain sustained eye closure
- Bulbar fatiguability - development of nasal speech with reading
- Proximal muscle fatigability - inability to maintain arms above the head
Signs of Management
- Thymectomy scar
Proximal Muscle Fatigability
How to Perform
- Ask the patient to hold their arms above their head for as long as they can.
Interpretation
- Inability to hold this position suggests proximal weakness, though if the patient is initially able to hold their arms up without issues then fatigues, this is a sign of myaesthenia.
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------