Question

A 60-year-old patient who has been diabetic for 20 years presents with acute dropping of the right eyelid. On manual elevation of the lid, he experiences double vision. Based on this information, what is the most likely diagnosis?

1) Bell's palsy
2) Horner's syndrome
3) Myasthenia gravis
4) Cavernous sinus thrombosis

Answer 1

The most likely diagnosis for the patient's acute drooping eyelid and double vision upon manual lid elevation is Myasthenia gravis, a condition characterized by muscle weakness affecting the eyes and other parts of the body.

Step-by-step explanation:

Based on the symptoms of acute dropping of the eyelid and the experience of double vision when the lid is manually elevated, the most likely diagnosis for a 60-year-old diabetic patient would be Myasthenia gravis. Bell's palsy typically presents with facial paralysis, Horner's syndrome with pupillary constriction and decreased sweating in the face, and cavernous sinus thrombosis with a broader range of cranial nerve deficits and signs of infection or severe headache. Myasthenia gravis, however, is characterized by muscle weakness that worsens with activity, which can manifest as drooping eyelids and double vision, or diplopia, due to weakness of the muscles involved in eye movement.