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Paradoxical lid elevation with sustained upgaze: a sign of Lambert-Eaton syndrome
L A Breen1, L Gutmann, J F Brick
1Department of Neurology, West Virginia University School of Medicine, Morgantown.
Abstract:
Myasthenia gravis and Lambert-Eaton myasthenic syndrome are causes of acquired extraocular muscle weakness and ptosis. Exacerbation of ptosis after sustained upgaze is a clinically useful sign in the diagnosis of myasthenia gravis. A 54-year-old woman with established Lambert-Eaton myasthenic syndrome exhibited transient improvement of her ptosis after sustained upgaze. We suggest that paradoxical lid elevation after sustained upgaze may be a clinically useful sign in distinguishing Lambert-Eaton myasthenic syndrome from myasthenia gravis.
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