Sustained Upgaze in Pediatrics — 7yo Child | Paediatric Neurology | SMLE Q#18640
SMLE Question #18640
Pediatrics
Paediatric Neurology
Objective: OBJ-NEURO-001
Last updated: February 2026
A 7-year-old child is brought to clinic for 3 months of intermittent bilateral eyelid drooping that worsens toward the evening. Parents report difficulty chewing during dinner and increasing fatigue by night. There is no fever and no recent diarrheal illness. Neurologic examination shows bilateral ptosis and mild facial weakness that increases with sustained upgaze; sensation and deep tendon reflexes are normal. What is the most appropriate next diagnostic test?
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