Simpson test is a clinical test used in neurology to determine ocular myasthenia gravis.[1] It was first described by the Scottish neurologist John Alexander Simpson.[2]

Simpson test
Purposedetermine ocular myasthenia gravis

Procedure

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In myasthenia gravis, there is a variable weakness of skeletal muscles, which is exacerbated by repeated contraction. To cause sustained contraction of levator palpebrae superioris muscle, the patient is asked to gaze upward for an extended period of time, without lifting the head. After a few minutes, the patient with myasthenia gravis starts to show drooping of upper eyelids, while normal individuals do not show any drooping.[3] Thus, this test can be used to clinically differentiate between ocular myasthenia gravis and normal individuals. Since myasthenia gravis affects all skeletal muscles, eyelid drooping is often bilateral. It is sometimes done in conjunction with tensilon test, where edrophonium is injected to look for reversibility of eyelid drooping. In myaesthenia gravis, eyelid drooping is no longer detectable after tensilon test. This test is less sensitive than anti-AChR antibody titers and electromyography, and hence is used only as a screening test in clinical setup.

References

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  1. ^ Nair, Akshay Gopinathan; Patil-Chhablani, Preeti; Venkatramani, Devendra V; Gandhi, Rashmin Anilkumar (2014). "Ocular myasthenia gravis: A review". Indian Journal of Ophthalmology. 62 (10): 985–991. doi:10.4103/0301-4738.145987. ISSN 0301-4738. PMC 4278125. PMID 25449931.
  2. ^ Riggs, Allison J.; Riggs, Jack E. (2004-02-10). ""Guessing it right," John A. Simpson, and myasthenia gravis: the role of analogy in science". Neurology. 62 (3): 465–467. doi:10.1212/01.wnl.0000106936.27018.ec. ISSN 1526-632X. PMID 14872032. S2CID 27047877.
  3. ^ "Archived copy" (PDF). Archived from the original (PDF) on 2017-12-01. Retrieved 2017-11-22.{{cite web}}: CS1 maint: archived copy as title (link)