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Arch Neurol. 2005;62:327.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 62-year-old woman was told that her left eyelid remained open when she looked downward as well as when she slept. Soon afterward, pain and weakness developed in her right leg. On admission 2 months later, her eyelids were symmetrical on forward gaze (the left eye was slightly lower), but the left upper eyelid elevated minimally on upgaze, failed to descend on downgaze, and did not relax on eyelid closure (Figure). Proptosis was absent, eye movements were full, and neither orbital pain nor diplopia occurred.

Figure appears in full text version. Figure. A, Upgaze. B, Forward gaze. C, Downgaze. D, Eyelid closure.

Physical examination revealed a 4x6-cm mass in the patient’s right breast, which proved to be an adenocarcinoma on biopsy. Radiographic investigation showed widespread lytic metastases in the skull, throughout the spine, in multiple ribs, in the pelvis and both femurs, and throughout the liver. Orbital scans were not performed. The . . . [Full Text of this Article]

AUTHOR INFORMATION

James R. Keane, MD

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