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Random question

A 34 year old woman presents with to your office with left eye ptosis, dysarthria, and difficulty standing up from a seated position. She states that the symptoms are the least intrusive first thing in the morning and get progressively worse all day. She has started to notice double vision as she drives home from a day of work. On exam you note ptosis of both eyelids, with the left being more dramatic. This ptosis is increased by continuous upward gaze. What would be the best first test to perform to make the diagnosis.

Topics: neurology
Contributor: Robyn McPherson
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