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Relapsing alternating ptosis in two siblings
  1. J P SIEB,
  2. A HARTMANN
  1. Department of Neurology, University Hospital, Bonn, D-53105, Germany
  1. Dr JP Sieb jp-sieb{at}t-online.de

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In this Journal, Peatfield described the recurrence of cluster headaches presenting with a virtually painless Horner's syndrome in a 56 year old man.1 This publication caused controversy on the dissociation between autonomic dysfunction and pain during cluster headache.2 We add to this discussion our report on relapsing alternating ptosis in two siblings:

A 46 year old woman had intermittent episodes of alternating ptosis for more than 8 years. Her 47 year old sister was affected similarly. As shown in figure 1, attacks occurred more often than once a month with a mean duration of the episodes of 8 days (range 3–14 days). Intrinsic oculomotor muscles and the bulbar muscles were spared (fig 2). She never complained about double vision. Elevating …

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