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.