{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T19:39:57Z","timestamp":1725737997805},"reference-count":5,"publisher":"Scientific Scholar","license":[{"start":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T00:00:00Z","timestamp":1610496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ruralneuropractice.com"],"crossmark-restriction":true},"short-container-title":["JNRP"],"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p>We report three cases of myasthenia gravis in whom the asymmetrical ptosis at presentation became more pronounced with the described bedside technique. Pronounced ptosis could be elicited by making the patient speak continuously for up to 2 minutes. Pauses for breathing and natural blinking were allowed. The sign is best elicited in newly diagnosed and treatment-naive patients. The loss of compensation for ptosis by frontalis muscle due to speech-induced fatigue may be responsible for the observed effect. Patients\u2019 symptoms abated on treatment with acetylcholine esterase inhibitors, steroids, and steroid-sparing agents.<\/jats:p>","DOI":"10.1055\/s-0040-1721559","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T23:55:00Z","timestamp":1610582100000},"page":"410-411","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pronounced Ptosis in Myasthenia Gravis\u2014A New Bedside Clinical Sign"],"prefix":"10.25259","volume":"12","author":[{"given":"Pulikottil W.","family":"Vinny","sequence":"first","affiliation":[{"name":"Department of Neurology, Indian Naval Hospital Ship Asvini, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venugopalan Y.","family":"Vishnu","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"issue":"1","key":"10.1055\/s-0040-1721559\/ref-1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41572-019-0079-y","article-title":"Myasthenia gravis","volume":"5","author":"Gilhus","year":"2019","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"10.1055\/s-0040-1721559\/ref-2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.ncl.2018.01.003","article-title":"Ocular myasthenia","volume":"36","author":"Al-Haidar","year":"2018","journal-title":"Neurol Clin"},{"issue":"8","key":"10.1055\/s-0040-1721559\/ref-3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1001\/archneur.1981.00510080093017","article-title":"Enhanced ptosis in myasthenia gravis","volume":"38","author":"Gorelick","year":"1981","journal-title":"Arch Neurol"},{"key":"10.1055\/s-0040-1721559\/ref-4","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1750-1172-2-44","article-title":"Myasthenia gravis","volume":"2","author":"Juel","year":"2007","journal-title":"Orphanet J Rare Dis"},{"issue":"12","key":"10.1055\/s-0040-1721559\/ref-5","first-page":"2047","article-title":"Relative fatigability of muscles in response to repetitive nerve stimulation in myasthenia gravis","volume":"89","author":"Witoonpanich","year":"2006","journal-title":"J Med Assoc Thai"}],"container-title":["Journal of Neurosciences in Rural Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ruralneuropractice.com\/pronounced-ptosis-in-myasthenia-gravis-a-new-bedside-clinical-sign\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ruralneuropractice.com\/pronounced-ptosis-in-myasthenia-gravis-a-new-bedside-clinical-sign\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,5]],"date-time":"2023-08-05T04:42:08Z","timestamp":1691210528000},"score":1,"resource":{"primary":{"URL":"https:\/\/ruralneuropractice.com\/pronounced-ptosis-in-myasthenia-gravis-a-new-bedside-clinical-sign\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,13]]},"references-count":5,"alternative-id":["10.1055\/s-0040-1721559"],"URL":"https:\/\/doi.org\/10.1055\/s-0040-1721559","relation":{},"ISSN":["0976-3147"],"issn-type":[{"value":"0976-3147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,13]]},"article-number":"410"}}