Eyelid ptosis from sympathetic nerve dysfunction mistaken as myopathy: a simple test to identify this condition.

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.

• Authors: G Tomelleri, G Vattemi, M Filosto, P Tonin
• Journal: Journal of neurology, neurosurgery, and psychiatry (J Neurol Neurosurg Psychiatry) Vol. 78 Issue 6 Pg. 632-4 (Jun 2007) ISSN: 1468-330X [Electronic] England
• PMID: 17287241 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenergic alpha-Agonists
• Ophthalmic Solutions
• Naphazoline

Topics

• Administration, Topical
• Adrenergic alpha-Agonists (administration & dosage)
• Adult
• Aged
• Autonomic Nervous System Diseases (complications, diagnosis)
• Blepharoptosis (etiology)
• Diagnostic Errors
• Female
• Horner Syndrome (complications, diagnosis)
• Humans
• Male
• Middle Aged
• Muscular Diseases (diagnosis)
• Naphazoline (administration & dosage)
• Ophthalmic Solutions (administration & dosage)