Brain Neurorehabil.  2023 Nov;16(3):e29. 10.12786/bn.2023.16.e29.

The Effect of Elastic Eyelid Band Application on Bilateral Severe Ptosis in a Patient With Bilateral Incomplete Claude’s Syndrome: A Case Report

• Ham CR
• Kim YW
• Park JM

• KMID: 2552317
• DOI: http://doi.org/10.12786/bn.2023.16.e29

Abstract

Patients with brainstem stroke can present with various oculomotor disorders, including ptosis. Neurogenic ptosis, which results from total or partial dysfunction of the third cranial nerve and/or the Müller muscle, can significantly restrict activities of daily living and participation in rehabilitation. Therefore, surgical intervention is an effective therapeutic strategy. However, owing to complications associated with incomplete eyelid closure, such as exposure keratitis and corneal injury, patients with neurogenic ptosis should first be observed, as natural recovery without surgery can be expected despite a poor prognosis. We reported the case of a 66-year-old woman with bilateral Claude syndrome who presented with severe bilateral ptosis, quadriparesis, and cognitive impairment after a bilateral midbrain infarction. After 3 months of intensive rehabilitation using soft elastic eyelid bands, her ptosis improved without the need for eyelid bands and visual field significantly increased, with improved functional level to the point of walking independently without assistance. This report demonstrates the potential advantages of the simple yet effective nonsurgical intervention of a soft elastic eyelid band for ptosis to restore significant functional gains in patients with severe bilateral ptosis after acute stroke.

Keyword

Midbrain; Cerebral Infarction; Rehabilitation; Treatment Outcome