Bilateral ptosis caused by midbrain hemorrhage: a case report

Abstract

Ptosis occurring in cases of cerebral ischemic or hemorrhagic stroke, trauma or tumor
without involvement of brainstem or oculo-sympathetic mechanism, can be termed as cerebral ptosis. Such eyelid dysfunction can occur with hemispheric involvement of either side. It is associated with higher frequency of gaze preference to side of lesion as well as upgaze limitation compared to patients without cerebral ptosis . Cerebral ptosis is rare. Eliminating an emergency is a real challenge in the face of bilateral ptosis. We report a case of bilateral ptosis occurring after a mesencephalic hematoma . The patient was unable to open her eyes, perform basic activities . Neurogenic ptosis may improve after treatment of the underlying cause.