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A collection of symptoms and signs indistinguishable from ocular myasthenia can be caused by an intracranial mass.We illustrate this condition with the case of an adolescent girl with neurofibromatosis type 1 and a dorsal midbrain astrocytoma.At presentation,she had fatigable ptosis,upgaze paresis,and a positive"lid twitch"sign.Radiation therapy resulted in marked reduction of her signs,confirming that the muscle fatigue was central in origin.We discuss the possible mechanisms of this central fatigability. |
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brainstem,glioma brainstem,glioma in children brainstem,neoplasms of lid twitch midbrain,lesion of midbrain,neoplasm of MRI MRI,abnormal myasthenia gravis,differential diagnosis myasthenia gravis,misdiagnosis of neoplasm,primary of CNS neurofibromatosis 1 ophthalmoplegia pseudomyasthenia ptosis upgaze,paralysis of
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