TY - JOUR T1 - Eyelid ptosis from sympathetic nerve dysfunction mistaken as myopathy: a simple test to identify this condition JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 632 LP - 634 DO - 10.1136/jnnp.2006.103432 VL - 78 IS - 6 AU - G Tomelleri AU - G Vattemi AU - M Filosto AU - P Tonin Y1 - 2007/06/01 UR - http://jnnp.bmj.com/content/78/6/632.abstract N2 - 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. ER -