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This case emphasises the significance of recognising fatigable ptosis and employing simple bedside assessments for the early diagnosis of juvenile autoimmune myasthenia gravis.<\/jats:p>","DOI":"10.1136\/bcr-2026-272395","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:40:26Z","timestamp":1781872826000},"page":"e272395","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Juvenile autoimmune myasthenia gravis: diagnostic utility of diurnal ptosis and the ice pack test"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7786-3765","authenticated-orcid":false,"given":"Akumtoshi","family":"Pongen","sequence":"first","affiliation":[{"name":"Zion Hospital and Research Centre, Dimapur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"2026061905401969000_19.6.e272395.1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1469-8749.2007.00629.x","article-title":"Childhood myasthenia: clinical subtypes and practical management","volume":"49","author":"Parr","year":"2007","journal-title":"Develop Med Child Neuro"},{"key":"2026061905401969000_19.6.e272395.2","first-page":"535","article-title":"Autoimmune myasthenia gravis in children","volume":"98","author":"Jayawant","year":"2013","journal-title":"Arch Dis Child"},{"key":"2026061905401969000_19.6.e272395.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70063-8"},{"key":"2026061905401969000_19.6.e272395.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(99)00709-5"},{"key":"2026061905401969000_19.6.e272395.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2004.00053.x"},{"key":"2026061905401969000_19.6.e272395.6","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12144781","article-title":"Detection of Antibodies against the Acetylcholine Receptor in Patients with Myasthenia Gravis: A Comparison of Two Enzyme Immunoassays and a Fixed Cell-Based Assay","volume":"12","author":"Gambino","year":"2023","journal-title":"J Clin Med"},{"key":"2026061905401969000_19.6.e272395.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70201-7"},{"key":"2026061905401969000_19.6.e272395.8","first-page":"439","article-title":"Disorders of the oculomotor nerve, trochlear nerve, and abducens nerve","volume":"102","author":"Miller","year":"2011","journal-title":"Handb Clin Neurol"},{"key":"2026061905401969000_19.6.e272395.9","first-page":"217","article-title":"Ocular myopathies and ophthalmoplegia","volume":"119","author":"Finsterer","year":"2009","journal-title":"Acta Neurol Scand"},{"key":"2026061905401969000_19.6.e272395.10","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.00743","article-title":"Management of Juvenile Myasthenia Gravis","volume":"11","author":"O\u2019Connell","year":"2020","journal-title":"Front Neurol"},{"key":"2026061905401969000_19.6.e272395.11","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/ene.12359","article-title":"EFNS\/ENS Guidelines for the treatment of ocular myasthenia","volume":"21","author":"Kerty","year":"2014","journal-title":"Eur J Neurol"},{"key":"2026061905401969000_19.6.e272395.12","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.7.1208"},{"key":"2026061905401969000_19.6.e272395.13","first-page":"912","article-title":"Juvenile myasthenia gravis: clinical features and outcome","volume":"27","author":"Della Marina","year":"2017","journal-title":"Neuromuscul Disord"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:40:28Z","timestamp":1781872828000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,19]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/bcr-2026-272395"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272395","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}