Variable ptosis after botulinum toxin type a injection with positive ice test mimicking ocular myasthenia gravis

Ahmad M. Alaraj, Darren T. Oystreck, Thomas M. Bosley

Research output: Contribution to journalArticlepeer-review

Abstract

We describe a patient who received cosmetic botulinum toxin type A injections to the brow and subsequently developed unilateral ptosis that was variable during examination and was transiently improved after the ice pack test. Ptosis gradually resolved spontaneously over approximately 3 months. This is the third patient to have variable ptosis documented after botulinum toxin type A injection to the brow and the second to have a positive ice test. The ice test is not completely specific for myasthenia gravis but may, at times, improve ptosis resulting from other defects at the neuromuscular junction. Wound botulism now is much more common because of illicit drug use, and the ice test also might be positive in this setting.

Original languageEnglish (US)
Pages (from-to)169-171
Number of pages3
JournalJournal of Neuro-Ophthalmology
Volume33
Issue number2
DOIs
StatePublished - Jun 1 2013
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology

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