{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T21:20:56Z","timestamp":1770412856164,"version":"3.49.0"},"reference-count":4,"publisher":"IMR Press","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2006,4]]},"abstract":"<jats:p>A 42-year-old woman presented to an eye clinic with a 2-week history of diplopia. Examination revealed signs of a right sixth nerve palsy. A computed tomography (CT) brain scan was normal. Six weeks later she presented during the acute medical take with increasing diplopia, a drooping right eyelid and unsteadiness. Direct questioning revealed that the drooping became progressively worse throughout the day. She had no relevant past medical history or any regular medication. Examination revealed a partial right ptosis and signs of right third, fourth and sixth nerve palsy. Diplopia on binocular vision resolved on patch testing; neurological examination was otherwise unremarkable, with no evidence of limb weakness.<\/jats:p>\n                  <jats:p>A magnetic resonance imaging scan of the brain and CSF examination were unremarkable. Ocular myasthenia was suspected, anti-acetylcholine receptor antibody test was requested, and a Tensilon test was performed with full resuscitation equipment available. Following the administration of the test dose (2 mg) of intravenous edrophonium (Tensilon) a visible improvement in the right ptosis was observed. Subsequent administration of a further 8 mg edrophonium yielded more marked improvement, with complete correction of the right ptosis (Figure 1) and a subjective decrease in diplopia on right gaze. A diagnosis of unilateral ocular myasthenia gravis was made on the basis of the clinical picture and the positive Tensilon test.<\/jats:p>\n                  <jats:p>A neurological opinion was sought and the patient commenced on pyridostigmine 60 mg four times a day. Further investigations included a CT scan of the thorax which revealed a 2 cm retrosternal mass, compatible with thymic hyperplasia. Five weeks after the positive Tensilon test, a report of strongly positive anti-acetylcholine receptor antibodies (anti-acetylcholine receptor antibodies &gt;8 nmol\/litre, normal range 0\u20130.5 nmol\/litre) was received. The diplopia continues to improve and the patient has regular follow up.<\/jats:p>","DOI":"10.12968\/hmed.2006.67.4.20871","type":"journal-article","created":{"date-parts":[[2014,5,23]],"date-time":"2014-05-23T09:38:29Z","timestamp":1400837909000},"page":"210-210","source":"Crossref","is-referenced-by-count":0,"title":["Unilateral ocular myasthenia gravis in an acute medical take: is a Tensilon test useful?"],"prefix":"10.31083","volume":"67","author":[{"given":"D","family":"McCarthy","sequence":"first","affiliation":[{"name":"Southend Hospital NHS Trust, Westcliff on Sea, Essex and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Patel","sequence":"additional","affiliation":[{"name":"Southend Hospital NHS Trust, Westcliff on Sea, Essex and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JAO","family":"Ahlquist","sequence":"additional","affiliation":[{"name":"Southend Hospital NHS Trust, Westcliff on Sea, Essex and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JW","family":"Stephens","sequence":"additional","affiliation":[{"name":"University of Wales Swansea and Morriston Hospital, Swansea SA2 8PP"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","reference":[{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050059"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.1988.tb06970.x"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2001.28038a"},{"key":"p_5","doi-asserted-by":"publisher","DOI":"10.1007\/BF01215447"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/hmed.2006.67.4.20871","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:19:42Z","timestamp":1770373182000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/67\/4\/10.12968\/hmed.2006.67.4.20871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,4]]},"references-count":4,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2006,4]]}},"alternative-id":["10.12968\/hmed.2006.67.4.20871"],"URL":"https:\/\/doi.org\/10.12968\/hmed.2006.67.4.20871","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,4]]}}}