Use of the Cogan Lid Twitch to Identify Myasthenia Gravis

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Title Use of the Cogan Lid Twitch to Identify Myasthenia Gravis
Creator Singman, Eric L; Matta, Noelle S; Silbert, David I
Affiliation Family Eye Group, Lancaster, Pennsylvania
Abstract To evaluate the reliability of the Cogan lid twitch (CLT) test in a neuro-ophthalmology clinic.CLT testing was performed on adult patients presenting to the neuro-ophthalmology clinic by the neuro-ophthalmologist. The patients were instructed to look straight ahead, up, down, and straight ahead again. The upper eyelids were carefully evaluated immediately following this movement for the presence of a brief upward twitch of the upper eyelid, which would indicate a positive CLT test. The test was repeated as needed. We evaluated the findings from the ophthalmologic examination along with results of available tests, such as serologic findings, MRIs, and CTs.Of 117 patients evaluated, 24 had myasthenia gravis (MG), and 18 of these patients had a positive lid twitch. Of the 98 patients who did not display a positive Cogan twitch, 6 had MG. We calculated the specificity of the CLT to be 99%, with a sensitivity 75% and false-positive rate 1%.The CLT test is a specific and sensitive test to use in a neuro-ophthalmology clinic to evaluate for MG.
OCR Text Show
Publisher Lippincott, Williams & Wilkins
Date 2011-09
Type Text
Rights Management © North American Neuro-Ophthalmology Society
Publication Type Journal Article
ARK ark:/87278/s6h16731
Setname ehsl_novel_jno
Date Created 2012-09-10
Date Modified 2014-07-10
ID 227181
Reference URL
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