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Isolated ipsilateral ptosis associated with ventral midbrain infarction: a case report and literature review

Xiao-Feng Cai1, Tian-Ming Shi1, Qi-Bing Wu2

  • 1Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, China.

The Journal of International Medical Research
|August 1, 2024
PubMed

Insights

Isolated ptosis can rarely result from midbrain infarction. This case highlights ventral midbrain infarction causing isolated ipsilateral ptosis, emphasizing the need for thorough neurological examination and imaging.

Area of Science:

  • Neurology
  • Neuroscience
  • Vascular Neurology

Background:

  • Ipsilateral ptosis is a rare symptom of midbrain infarction.
  • Misdiagnosis as myasthenia gravis is possible for isolated ptosis.

Purpose of the Study:

  • To report an extremely rare case of isolated ipsilateral ptosis caused by ventral midbrain infarction.
  • To discuss the potential mechanisms and diagnostic considerations for this condition.

Main Methods:

  • Case presentation of a patient with isolated ipsilateral ptosis.
  • Diagnostic workup including magnetic resonance imaging (MRI).
  • Review of potential pathophysiological mechanisms.

Main Results:

  • The patient presented with isolated ipsilateral ptosis, initially suspected to be myasthenia gravis.
  • Ventral midbrain infarction was diagnosed via MRI, attributed to selective damage of the oculomotor nerve's levator palpebral muscle branch.
  • The patient received aspirin and atorvastatin, showing improvement in ptosis within 5 days and complete resolution after 1 month.

Conclusions:

  • Ventral midbrain infarction can present as isolated ipsilateral ptosis, a rare clinical manifestation.
  • Prompt diagnosis requires careful neurological examination and neuroimaging, particularly in patients with cerebrovascular risk factors.
  • Early treatment with antiplatelets and statins may aid in recovery.
Keywords:
Isolated ipsilateral ptosiscase reportice pack testmagnetic resonance imagingmyasthenia gravisventral midbrain infarction

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