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Ptosis

  • Common Ddx

    • Old age (Levator Dehiscence), congenital variant
    • Myesthenia gravis
    • Periorbital edema
      • nephrotic syndrome
      • allergic reaction, insect bite, stings
      • lid infections
    • Migraines, cluster headaches
  • Serious ddx

    • CN III palsy
      • cerebral aneurysm
      • cavernous sinus thrombosis
      • MS
    • Horner's syndrome
      • stroke (lateral pontine, medullary syndrome)
      • spinal cord lesion
      • carotid dissection
      • pancoast tumor
      • lung cancer, lymphoma
    • Periorbital edema
      • preorbital cellulitis
      • orbital cellulitis
  • Labs

    • eye exam, slit lamp
    • CBC, chem
    • a1c if suspect diabetic neuropathy
    • ESR
    • CK if suspect myopathy, f/u muscle biopsy if elevated
    • RPR/VDRL if suspect neurosyphilis
    • UA
    • CT head and neck if pupil is dilated or papilledema
    • CXR or CT chest if suspect tumor causing horner's
    • MG panel if suspected
  • Other ddx

    • Myopathy
      • mitochondrial myopathy
      • myotonic dystrophy
    • neurosyphilis
    • diabetic neuropathy

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.