Annals of Indian Academy of Neurology
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Year : 2011  |  Volume : 14  |  Issue : 3  |  Page : 208-210

Cysticercosis of midbrain presenting with fluctuating ptosis

1 Department of Neurology, Narayana Hrudayalaya Institute of Neurosciences, Bangalore, India
2 Department of Neurosurgery, Narayana Hrudayalaya Institute of Neurosciences, Bangalore, India

Correspondence Address:
M Netravathi
Narayana Hrudayalaya Institute of Neurosciences, Narayana Multispeciality Hospital, Bangalore - 560 099
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-2327.85898

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Fluctuating ptosis is usually caused by Myasthenia gravis. There are a few case reports of central causes of fluctuating ptosis. A 58-year-old man presented with fluctuating ptosis of one year duration. He was diagnosed as having ocular myasthenia and investigated. On evaluation, his electrophysiological tests revealed negative decremental response and results of neostigmine test was negative. During follow-up, patient developed headache. Imaging of the brain revealed midbrain cysticercosis granuloma. The focal encephalitis and edema was responsible for fluctuating ptosis. It is therefore essential to be aware of conditions that cause such pseudomyasthenic features. Patients with ptosis need to be evaluated for other rare central cause especially when neostigmine test is negative.

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