Psychogenic pseudoptosis: Case report with review of literature

Purpose: Psychogenic ptosis is a rare ophthalmic manifestation of conversion disorder. The aim of this study was to describe the clinical parameters, etiology, psychological, and clinical aspects of psychogenic ptosis. Methods: A retrospective case series was conducted of patients with psychogenic ptosis seen between 1990 to 2020. Medical records were reviewed for patient demographics, including psychiatric history, clinical findings, diagnostic studies, treatment, and resolution rates. A literature review was performed to identify cases of psychogenic ptosis previously published between 1990 and 2020. Results: Six female patients (aged 14–60 years) were diagnosed with unilateral psychogenic ptosis. Physical trauma preceded the onset of ptosis in all cases. Imaging studies had been previously obtained in all patients, none of who were correctly diagnosed at time of referral. Associated signs included concurrent brow ptosis, orbicularis oculi spasm, squint on upgaze, and variable levator function and eyelid margin measurements. Four patients had preexisting psychological conditions. Patients were primarily managed with reassurance. Conclusions: Psychogenic ptosis is an often delayed or misdiagnosed condition, resulting in unnecessary referrals and imaging. Psychogenic ptosis should be considered in patients with atypical findings of ptosis including ipsilateral brow depression, orbicularis oculi spasm, squint on upgaze, and variable eyelid measurements. A prior history of minor trauma and female sex were common in this series. Our experience suggests that psychogenic ptosis can often be treated with reassurance, leading to partial or complete resolution. Given the number of patients with comorbid psychiatric conditions, the authors recommend a low threshold for psychiatric or psychological evaluation.

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“…The authors were able to identify nine cases of psychogenic ptosis that have been published in the literature (Table 2). 3–8…”

Section: Discussionmentioning

confidence: 99%

“…The authors were able to identify nine cases of psychogenic ptosis that have been published in the literature (Table 2). [3][4][5][6][7][8] All patients in our study were female. There was a 2:7 ratio of males to females with psychogenic ptosis documented in the literature.…”

Section: Discussionmentioning

confidence: 99%

Psychogenic Ptosis

Couch

Custer

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Sensory symptoms include anesthesia, paresthesia, deafness, blindness & tunnel vision and hallucinations. (5). There is usually some hesitation when it comes to making a diagnosis of conversion disorder, because of several previous studies that have peculiarly pointed out the unacceptably common misdiagnosis rates.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Neurological Disorders Misdiagnosed as Conversion Disorder in our Local Population

Butt¹,

Jabbar²,

Akhtar³

et al. 2022

PJMHS

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Aims and Objectives: To determine the frequency of Neurological Disorders, Misdiagnosed as Conversion Disorder in our local population Study Design: Cross sectional study Place and Duration of Study: Study was conducted at Psychiatry Department, Akhtar Saeed Medical College & Hospital, Lahore Pakistan, from June, 2021 to December, 2021. Data Collection: After meeting the inclusion criteria 115 patients were enrolled. CT brain, MRI brain and EEG were carried out to assess neurological symptoms in patients admitted with a diagnosis of conversion disorder. Misdiagnosis was labeled as per operational definition. All the data analyzed on SPSS version 23. Results: In this study the mean age was (27.03±11.95) years, male to female ratio was 0.36:1. The CT and MRI diagnosed abnormal finding in 7(6.1%) patients, while EEG was abnormal in 2(1.7%) of these 7 patients, resulting in neurological disorders being diagnosed in 7(6.1%) patients. Hence, in this study misdiagnosed cases were 7(6.1%). Conclusion: This study concluded that frequency of Neurological Disorders Misdiagnosed as Conversion Disorder is 6.09% in our local population. Keywords: Conversion Disorder, Neurological disorder, EEG, MRI, CT

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Psychogenic pseudoptosis: Case report with review of literature

Cited by 2 publications

References 12 publications

Psychogenic Ptosis

Psychogenic Ptosis

Frequency of Neurological Disorders Misdiagnosed as Conversion Disorder in our Local Population

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