Differential Diagnosis for Dropping of One Eyelid and Headache on the Same Side
- Single Most Likely Diagnosis
- Horner's Syndrome: A neurological disorder characterized by a triad of ptosis (drooping eyelid), miosis (pupil constriction), and anhidrosis (lack of sweating) on the same side of the face, often accompanied by headache. The most common cause is a stroke or carotid artery dissection.
- Other Likely Diagnoses
- Migraine with Ptosis: Some migraines can cause drooping of the eyelid on the same side as the headache, although this is less common.
- Cluster Headache: These severe headaches can cause ptosis and are typically accompanied by other symptoms like nasal congestion and eye watering on the same side.
- Temporal Arteritis: Inflammation of the temporal artery can cause headache and, in some cases, drooping of the eyelid due to involvement of the nerves supplying the eye muscles.
- Do Not Miss Diagnoses
- Aneurysm or Arteriovenous Malformation (AVM): Although rare, these vascular abnormalities can cause sudden, severe headache and, if affecting nerves, could lead to ptosis. Missing these diagnoses could be fatal.
- Pituitary Apoplexy: A condition where the pituitary gland suddenly hemorrhages or becomes infarcted, leading to severe headache and potential visual disturbances, including ptosis.
- Cavernous Sinus Thrombosis: A blood clot in the cavernous sinus can cause headache, ptosis, and other neurological symptoms due to its location near critical nerves and blood vessels.
- Rare Diagnoses
- Myasthenia Gravis: An autoimmune disease that can cause muscle weakness, including the muscles around the eye, leading to ptosis. It is less commonly associated with headache.
- Tolosa-Hunt Syndrome: A rare disorder characterized by headache, ptosis, and other symptoms due to inflammation of the cavernous sinus or superior orbital fissure.
- Syphilis: In its tertiary stage, syphilis can cause a variety of neurological symptoms, including ptosis and headache, although this is very rare in the modern era with access to antibiotics.