235 EYES WIDE SHUT: A CASE OF BILATERAL PTOSIS FOLLOWING STROKE

Abstract Background Bilateral ptosis is a rare manifestation of midbrain stroke. It has been reported in case studies only, with no data on incidence rate, and published report Ireland to date. Methods This retrospective study man admitted an acute stroke unit following collapse unresponsiveness. A review his medical records radiological database was conducted. PUBMED search conducted for similar cases. Results We present the who had witnessed whilst farming brought hospital presented Glasgow Coma Scale 3. Imaging showed normal CT Brain. MRI revealed 2cm bilateral thalamic infarction. Following brief period ICU he transferred multidisciplinary care. Despite improvements status communication efforts, inability open eyes contributed persistently low GCS. Neurological assessment ptosis, fixed dilated pupils oculomotor paralysis. These symptoms profound impact recovery, impeding assessments interventions engagement all realms (swallow communication; mobility function, cognitive-perceptual) also limiting opportunities social interaction. Once staff became aware ophthalmoplegia, strategies were implemented optimise participation provide recovery. Three months post stroke, began experience some return unilateral eye-opening horizontal movements (with diplopia) which greatly improved overall performance. He then rehabilitation where continues progress. Conclusion debilitating effect aspects living interaction environment. presentation previously described as “reverse locked-in-syndrome” accurately represents its impact.