Question

A healthy 62-year-old female patient comes into your primary care clinic with complaints of diplopia and ptosis that has been worsening over the last few months. She states she has had slightly blurry vision and halo around objects. She has noticed her chewing and swallowing has become more difficult recently and she seems to choke on her food more frequently.

what would be 3 different diagnoses ?

thank you!

Patient has no previous medical history. She takes a multi-vitamin and exercises daily. She has a history of rheumatoid arthritis, which is mild and controlled with anti-inflammatory medications. She has no history of any serious conditions. She has no surgical history. She is up to date with her vaccinations.

Answer 1

The three diagnoses for the condition of diplopia (double vision) and ptosis (eyelid drooping),difficulty in chewing and swallowing would be from the neurogenic and myogenic causes-

1. Oculomotor nerve palsy -The oculomotor nerve palsy occurs due to the damage of third cranial nerve results into the double vision,drooping eyelids,blurry vision and halo around the objects

2.Myasthenia gravis - The myasthenia gravis is the autoimmune disease affects the neuromuscular system, results into the weakness of the skeletal muscles. It causes the difficulties in chewing and swallowing due to affected muscles of face and swallowing.

3.Oculopharyngeal muscular dystrophy - The oculopharyngeal muscular dystrophy is the progressive genetic muscular disorder,affects the upper eyelids muscles  and throat(pharyngeal muscles).