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American Academy of Neurology (AAN), Neurology, 10(81), p. e71-e72, 2013

DOI: 10.1212/wnl.0b013e3182a351e7

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Teaching Neuro Images : Awakening ptosis (unilateral hypnopompic eyelid palsy)

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Data provided by SHERPA/RoMEO

Abstract

A healthy 68-year-old woman presented with 2 years of recurrent episodes of right ptosis, constantly present after waking from sleep (figure 1). Clinical examination, brain MRI, EMG, and polysomnography were unremarkable (figure 2). In particular, there was no cranial nerve impairment. Few cases of idiopathic ptosis on awakening have been described, and attributed to eyelid opening apraxia.(1) This disorder needs to be differentiated from myasthenia gravis and other neuromuscular disorders.(2) We propose that the term apraxia is not suitable to describe this clinical phenomenon, which could result from an abnormal, transient persistence of focal, sleep-related muscular atonia.