Eyelid ptosis from sympathetic nerve dysfunction mistaken as myopathy: a simple test to identify this condition. Issue 6 (7th February 2007)

• Record Type: Journal Article
• Authors: Tomelleri, G; Vattemi, G; Filosto, M; Tonin, P
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 78:Issue 6(2007)
• Page Start: 632
• Page End: 634
• Publication Date: 2007-02-07
• Subjects: AchR, acetylcholine receptor -- EMG, electromyography; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2006.103432
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Acquired isolated unilateral or bilateral blepharoptosis has many aetiologies. When the pupils are normal, a myasthenic syndrome or myopathy has to be ruled out. If the tests for myasthenia gravis are negative, the next step is to perform a muscle biopsy to establish a diagnosis. Muscle examination may show a mitochondrial disorder, non-specific abnormalities or be quite normal. We identified three patients, who had previously undergone various investigations, including a muscle biopsy, whose lid ptosis disappeared using eye drops containing naphazoline nitrate, a sympathomimetic drug, thus suggesting partial Horner's syndrome. We emphasise the usefulness of this simple and cheap test before performing more traumatic and expensive investigations.