Neurol Case Rep | Volume 6, Issue 1 | Case Report | Open Access

Loss of Vision due to Bilateral Ptosis in a 96-Year-Old Woman – A Case Report

Klemke LL1*, Focke JK1 , Teichert NA2 , Ringelstein M1,3 and Seitz RJ1,3

1Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Heinrich-HeineUniversity Düsseldorf, Germany 2Department of Radiology, Heinrich-Heine-University Düsseldorf, Germany 3Department of Neurology, Heinrich-Heine-University Düsseldorf, Germany

*Correspondance to: Leonard Leopold Klemke 

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Objectives: Bilateral ptosis is a very seldom presentation and an interesting clinical challenge because of the wide range of possible differential diagnoses of this neurological sign. We report a case of nuclear oculomotor nerve syndrome due to isolated symmetric midbrain ischemia as a rare cause. Through this case report, we aim to determine the difference between a bilateral ptosis with lesion in the oculomotor nucleus, ocular myasthenia gravis or Miller Fischer (MF) syndrome with difficulty in initiating the act of lid elevation, in spite of adequate understanding, motor control and cranial nerve pathways. Methods: The case report of a 96-year-old woman presenting bilateral ptosis without relative afferent pupillary defect and ischemic lesion in the midbrain. Results: Our patient suffered a midbrain stroke caused by paroxysmal atrial fibrillation. Conclusion: Our case report confirms multiple differential diagnoses in bilateral ptosis and the importance of clinical examination in spite of good neurological imaging.


Embolism; Stroke; Clinical neurology examination; MRI; Case report


Klemke LL, Focke JK, Teichert NA, Ringelstein M, Seitz RJ. Loss of Vision due to Bilateral Ptosis in a 96-Year-Old Woman – A Case Report. Neurol Case Rep. 2023;6(1):1038..

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