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| CASE REPORT |
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| Year : 2020 | Volume
: 66
| Issue : 3 | Page : 162-164 |
Plus-minus lid syndrome with ataxia and severe apathy—A rare manifestation of midbrain infarct
S Sheetal, R Thomas, AS Kumar, LG Tomy
Department of Neurology, Pushpagiri Institute of Medical Sciences and Research, Tiruvalla, Kerala, India
Correspondence Address:
A S Kumar
Department of Neurology, Pushpagiri Institute of Medical Sciences and Research, Tiruvalla, Kerala
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jpgm.JPGM_709_19
Plus-minus lid syndrome is a rare manifestation of midbrain infarct, characterized by ptosis of one eye and lid retraction in the other eye. It has also been described in ocular myasthenia gravis, orbital myositis, or after lesions of the oculomotor nerve. Our patient was a 55-year-old man with hypertension and atrial fibrillation, who presented to us with acute onset left-sided ptosis and right-sided eyelid retraction. He was apathic and had right-sided ataxia. His MRI of the brain showed acute infarct involving the paramedian midbrain. To our knowledge, severe apathy and resultant executive function disorder have not been described previously in a patient having plus-minus lid syndrome with ataxia.
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