Ptosis
Ptosis is a very
interesting problem that can be due to multiple causes. Two forms of ptosis
deserve special attention.
One is Ptosis associated with miosis and the second one is ptosios
associated with mydriasis. The former is due to Horner's syndrome
(affects the sympathetic pathway) and the second (with mydriasis) which
is due to parasympathetic loss with 3rd nerve palsy.
The sympathetic path is thoracolumbar and the parasympathetic is
craniosacral. If a has a lesion in the sympathetic system, it could be anywhere
between the brain and the first cervical ganglion. Typically Horner,s syndrome will be
presented with a patient with a pancoast,s syndrome and one will either be shown a CXR or
asked what investigation should be next if a CXR is not shown. Remember that the
peripheral lesions are mainly Adenocarcinomas. Alveolar cell Ca too is peripheral.