• Upper lid and vertical eye movements are usually preserved in patients with the "locked-in" syndrome, a condition manifested by anarthria, spastic quadriparesis, and intact mental function, and caused by lesions in the ventral portion of the pons. We describe a presumed mesencephalic "locked-in" syndrome in a patient who had total bilateral ptosis at the onset of his disease and later on experienced complete bilateral oculomotor nerve paralysis.
Meienberg O, Mumenthaler M, Karbowski K. Quadriparesis and Nuclear Oculomotor Palsy With Total Bilateral Ptosis Mimicking Coma: A Mesencephalic 'Locked-in Syndrome'? Arch Neurol. 1979;36(11):708–710. doi:10.1001/archneur.1979.00500470078016
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