The Differential Diagnosis of Ptosis

In the emergency department, if a patient comes in with... I would start with unilateral ptosis. Either a third nerve palsy or a horn or syndrome. If it's bilateral ptosis, then you start thinking about sort of neuromuscular things like myasthenia gravis or botulism. Let's go back to the case. This 30-year-old woman was sent home with a follow-up appointment only to return to the ED three days later with cough, shortness of breath, and difficulty speaking. She's now in your acute area in a stretcher on a cardiac monitor. She's a little bit drowsy and tachypneic with