Bilateral ptosis with ophthalmoplegia externa in paediatric onset multiple sclerosis: A case report

Paediatric onset multiple sclerosis (POMS) patients usually present with a diminution of vision pertaining to optic neuritis and experience a more aggressive disease onset with disabling clinical symptoms, a polyfocal presentation at disease onset, and a higher relapse rate early in the disease course. We are reporting a unique presentation of bilateral ptosis with external ophthalmoplegia in a patient of a 17-year-old female patient who came with chief complaint of drooping of lids in both eyes for 3 years. Complete ophthalmic and systemic examination was done. Patient was diagnosed as MS according to the revised Mcdonald criteria and was given Methylprednisolone Pulse therapy. We concluded that acquired bilateral ptosis with ophthalmoplegia externa should be given special attention to rule out systemic associations. Timely diagnosis and early management of multiple sclerosis in the pediatric age group with DMT may reduce relapse frequency and functional disability.