Evaluation of two non-myasthenic patients with ptosis

Decreased height of the eyelid or the narrowing of the lid is called ptosis. Ptosis has several causes. Malignancy-related conditions such as Horner's syndrome, which causes unilateral ptosis in the pediatric age group, and patients with malignancy receiving chemotherapeutic treatment, are often secondary to these drugs and ptosis is a clue of underlying diseases. Underlying pathologies can lead to different clinical conditions such as cognitive impairment from coma, the presence of ptosis should be cautionary. In this study, we present two patients with malignancy who were admitted with ptosis. The first patient was diagnosed as having neuroblastoma and treated with neuroblastoma-directed chemotherapeutics. The second patient was diagnosed as having acute lymphoblastic leukemia and developed vincristine-induced ptosis and recovered on treatment with pyridoxine and pyridostigmine. In conclusion, non-myasthenic ptosis may develop due to involvement of the central nervous system during malignancy or neurotoxic effects of chemotherapeutic agents. Therefore, patients who present with ptosis should be evaluated for the etiologic diagnosis.