Psychogenic pseudoptosis: Case report with review of literature

Abstract

Background

Conversion disorder or functional neurological disorder is a psychiatric condition in which the body’s emotional and psychological stressors are converted to physical symptoms that cannot be explained by a neurological or medical condition. Psychogenic pseudoptosis is a rare manifestation of conversion disorder that present a major challenge in terms of diagnosis and treatment.

Case description

A 36-year-old woman presented with acquired left ptosis and longstanding generalized weakness. She denied any toxic substance exposure, insect bites, recent travel or family history of neurological disease. The neurological examination was normal except for an atypical left ptosis with eyebrow droop and inability to walk. However, electrophysiological investigations were normal. The presence of dissociative symptoms and the improvement after starting pharmacotherapy in combination with psychotherapy led to the diagnosis of conversion disorder.

Conclusion

After the exclusion of organic causes, the conversion disorder must be considered in the differential diagnosis of acquired ptosis, especially when accompanied by eyebrows droop sign and a suggestive psychological context.