Recurrent isolated ptosis in presumed ophthalmoplegic migraine of childhood.

PURPOSE: To report a rare case of isolated, recurrent unilateral eyelid ptosis as the sole manifestation of ophthalmoplegic migraine in a healthy young girl.

DESIGN

Single observational case report with review of the literature.

TESTING: Serologic evaluation, electromyographic, nerve conduction and Tensilon testing, magnetic resonance and computerized tomographic imaging, and magnetic resonance angiography were performed.

MAIN OUTCOME MEASURES: Four-year descriptive history of recurrent eyelid ptosis.

RESULTS

Between 1994 and 1998, seven discrete episodes of right upper eyelid ptosis without ophthalmoplegia or pupil abnormality occurred. On each occasion, spontaneous resolution occurred over a period of 6 to 10 weeks. Extensive clinical and laboratory evaluation, including testing for myasthenia gravis and magnetic resonance cerebral angiography, was unremarkable.

CONCLUSIONS

Recurrent isolated ptosis is a rare manifestation of presumed ophthalmoplegic migraine in childhood. As far as we are aware, this has not been previously reported.