PMC9307397_01
Bilateral partial ptosis with overaction of the frontalis muscle.
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fig1
She had neck muscle weakness and asymmetrical external ophthalmoplegia (Figure 1).
Decremental response of 10% seen on repetitive stimulation of the facial nerve.
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fig2
This was substantiated by the repetitive nerve stimulation test, wherein at 1 Hz rate stimulation, the orbicularis oculi muscles showed a decremental response consistent with the diagnosis of myasthenia gravis (Figure 2).