2007 issue 1

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Volume 16, issue 1

Case report

Blepharoptosis as a diagnostic and therapeutic problem in a patient with coexistent myasthenia gravis and dystonia - case report

Agnieszka Machowska-Majchrzak1, Krystyna Pierzchała1, Klaudiusz Kumor1, Róża Ślusarczyk1, Wojciech Bartman1, Jolanta Biernawska1
1. Katedra i Klinika Neurologii Śląskiej Akademii Medycznej w Zabrzu
Postępy Psychiatrii i Neurologii 2007; 16 (1): 93-96
Keywords: blepharoptosis, dystonia, blepharospasm, myasthenia gravis, botuline toxin

Abstract

Objective. Blepharoptosis is a rather common but nonspecific symptom of various neurological conditions. Diagnostic difficulties related to coexistence of two disorders with the symptom of drooping eyelids are discussed in the paper.
Case report. A case is presented of a 64-year-old man admitted to our department with a two-year history of periodic bilateral ptosis. On the grounds of the clinical picture and diagnostic procedures the patient was diagnosed with myasthenia gravis and concomitant blepharospasm. The asymmetry of palpebral fissures subsided after pyridostygmine therapy. While botuline toxin injections resulted in an improvement of blepharospasm, no evidence of the myasthenic symptoms deterioration was found.
Commentary. In the proper planning of diagnostic procedures and treatment the possibility of coexistence of different disorders characterized by drooping eyelids should be taken into account.

Address for correspondence:
Dr Agnieszka Machowska-Majchrzak
Klinika Neurologii Śląskiej Akademii Medycznej
ul. 3 Maja 13/15, 41-800 Zabrze
tel. (32) 2710975
fax: (32) 2713018
e-mail: majfam@ka.onet.pl