Brainstem stroke presenting as isolated bilateral ptosis

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Pure midbrain infarctions are rare neurological events.
• Isolated bilateral ptosis as the sole symptom is exceptionally uncommon.

Observation:

• An elderly patient presented with isolated bilateral ptosis.
• The initial diagnosis considered myasthenia gravis.

Findings:

• The patient was diagnosed with a perforator infarct in the midbrain.
• The midbrain infarct was the cause of the isolated bilateral ptosis.

Implications:

• Highlights the importance of considering midbrain infarcts in cases of isolated ptosis.
• Early identification of this rare condition is key to appropriate management.
• Undiagnosed midbrain lesions can lead to significant downstream complications.