Neuro-ophthalmology Service, Alkek Eye Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Ophthalmology. 2010 Jun;117(6):1265-8. doi: 10.1016/j.ophtha.2009.10.032. Epub 2010 Feb 16.
To report a case series of patients with benign unilateral apraxia of eyelid opening.
Retrospective, observational case series.
Five patients with unilateral transient ptosis after sleep from a single neuro-ophthalmology practice.
A list of 208 patients with ptosis seen at a single neuro-ophthalmology practice was drawn through the computer coding system. Transcribed reports of the outpatient visits of these patients were reviewed from this database to identify the final diagnoses. All patients with a diagnosis of ptosis resulting from underlying neurologic, myopathic, or neuromuscular problems were excluded. Five patients with ptosis that occurred on awakening and resolved after mechanical eyelid elevation were included.
The main outcome measure was identifying and defining a group of patients with a benign clinical entity causing ptosis that can cause a clinical dilemma.
Three of 5 patients were women. Ages ranged from 49 to 71 years. All patients experienced complete ptosis only on awakening after sleep. The ptosis was unilateral and did not recur after manual elevation of the eyelid. None of the patients had any underlying neurologic problem that could be contributory and were thoroughly investigated with neuroimaging and laboratory testing, including acetylcholine receptor antibodies. Examination revealed no ocular cause for the ptosis in each patient. In all patients, follow-up telephone reports noted no subsequent condition that could be responsible for ptosis.
The identification and diagnosis of this form of isolated ptosis, which herein is termed benign unilateral apraxia of eyelid opening, is of importance in that extensive evaluation is not warranted unless there are other neurologic or ocular findings.
报告一组单侧动眼神经麻痹性上睑下垂患者的病例系列。
回顾性、观察性病例系列。
单一眼神经科诊所的 5 例单侧暂时性上睑下垂患者，均于睡眠后发生。
通过计算机编码系统绘制了 208 例上睑下垂患者的名单。从该数据库中审查了这些患者的门诊就诊记录的转录报告，以确定最终诊断。所有因潜在神经、肌肉或神经肌肉问题导致上睑下垂的患者均被排除在外。纳入 5 例因机械性眼睑抬高后上睑下垂且上睑下垂在觉醒时发生并缓解的患者。
主要观察指标是确定并定义一组良性临床实体引起的上睑下垂患者，这些患者可能会引起临床困惑。
5 例患者中有 3 例为女性。年龄范围为 49 岁至 71 岁。所有患者仅在睡眠后觉醒时出现完全上睑下垂。上睑下垂为单侧，且经手动抬起眼睑后不再复发。无任何潜在的神经问题可能导致这种情况，所有患者均进行了神经影像学和实验室检查，包括乙酰胆碱受体抗体检查，进行了彻底检查。对每位患者的检查均未发现上睑下垂的眼部原因。在所有患者中，后续电话报告均未发现可引起上睑下垂的后续疾病。
这种孤立性上睑下垂形式的识别和诊断很重要，因为除非存在其他神经或眼部表现，否则无需进行广泛评估。在此，这种形式被称为良性单侧动眼神经麻痹性上睑下垂。
