A 27-year-old woman was presented with a 1-month history of a drooping left eyelid that worsened in the afternoon. She reported no other neurologic symptoms (like diplopia, weakness, numbness, weakened limbs or disturbed speech, or swallowing). Examination Her pupils were equal, round, and reactive to light and accommodation. Prominent ptosis of the left eyelid was observed, which worsened with a sustained upward gaze. The right eyelid did not show any signs of ptosis.
However, manual elevation of the left eyelid induced ptosis of the right eyelid. Laboratory evaluation indicated: acetylcholine-receptor–antibody level of 4.56 nmol/liter (normal value, <0.05 nmol /liter) Identify this neuromuscular condition. *This case is from Doplexus Editorial team for educative purpose only. Source: NEJM Stay Connected, the answer will be posted in the next 48h!
