Acute Bilateral Ptosis as the Sole Manifestation of Neurocysticercosis in a Child

Abstract

FIGURE 1. Bilateral ptosis at the time of admission. A 14-year-old girl who had previously lived in Cape Verde presented with a 24-hour history of almost complete bilateral ptosis (Fig 1). Extraocular movements were intact, pupils were equally reactive to light, and optic disc edema was not present. All other cranial nerves were intact and there were no other neurological or systemic signs. Brain magnetic resonance imaging showed two small ring-enhancing parenchymal cysts (in the midbrain [Fig 2] and in the left frontal convexity), with perilesional edema, consistent with neurocysticercosis. She was treated with oral dexamethasone and albendazole for 7 days with complete resolution of ptosis after 3 days of therapy. During follow-up (18