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Eyelid ptosis from sympathetic nerve dysfunction mistaken as myopathy. A simple test to identify this condition
  1. Giuliano Tomelleri (giuliano.tomelleri{at}univr.it)
  1. Department of Neurological Sciences, Section of Clinical Neurology, University of Verona, Italy
    1. Gaetano Vattemi (gaetano.vattemi{at}univr.it)
    1. Department of Neurological Sciences, Section of Clinical Neurology, University of Verona, Italy
      1. Massimiliano Filosto
      1. Department of Medical and Surgical Sciences, Clinical Neurology, University and Hospital, Italy
        1. Paola Tonin (paola.tonin{at}azosp.vr.it)
        1. Department of Neurological Sciences, Section of Clinical Neurology, University of Verona, Italy

          Abstract

          Acquired isolated unilateral or bilateral blepharoptosis has many aetiologies. When pupils are normal, a myasthenic syndrome or a myopathy have to be ruled out. If the tests for myasthenia gravis are negative, the next step is to perform a muscle biopsy in order to establish a diagnosis. Muscle examination may show a mitochondrial disorder, non specific abnormalities or be quite normal. We have single out three patients, previously submitted among various investigations also to a muscle biopsy, whose lid ptosis disappeared by using eyedrops containing naphazoline nitrate, a sympatomimetic drug, thus suggesting a partial Horner’s syndrome. We emphasize the usefulness of this simple and cheap test before performing more traumatic and expensive investigations.

          • eyelid ptosis
          • naphazoline nitrate
          • partial horner’s syndrome

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