Ptosis associated with iatrogenic pneumothorax: a false lateralizing sign.

Two cachectic, obtunded patients were seen with unilateral periorbital emphysema resembling ptosis as a primary manifestation of pneumothorax. Speculation is made as to the possible role of malnutrition in this unusual manifestation. Spontaneous pneumothorax should be considered in the obtunded patient with ptosis that is poorly explained by other neurologic findings.