Domínguez-Gasca LG, Domínguez-Carrillo LG

Idioma: Español
Referencias bibliográficas: 31
Paginas: 67-72
Archivo PDF: 98.53 Kb.

RESUMEN

Introducción: En 1950 Vernon Brooks demuestra que la toxina botulínica bloquea la liberación de acetilcolina de las motoneuronas; en los años sesenta Scout la utiliza en estrabismo; es aprobada en el 2002 para tratamientos estéticos, su efecto indeseable más frecuente cuando se infiltra en zona periorbitaria es la blefaroptosis. Caso clínico: Paciente femenino de 56 años que sufre choque automovilístico, presentando dolor cervical intenso. Es manejada con collarín cervical y enviada al cuarto día del percance a rehabilitación; un día antes de acudir presenta blefaroptosis izquierda e hipoestesia en territorio T8-D1 en miembro superior ipsilateral; negó en forma reiterada la aplicación de toxina botulínica; en la exploración blefaroptosis izquierda parcial, reflejos fotomotor, consensual y de acomodación normales con pupilas isocóricas; sus radiografías muestran discartrosis; la resonancia: hernias discales C4-C5, C5-C6 y retrolistesis C4-C5. Se niega a tratamiento quirúrgico y es reenviada a rehabilitación; manejada conservadoramente; se da de alta asintomática a los 4 meses; aceptando por fin que un día antes del accidente le habían aplicado toxina botulínica en cara y que lo negó por vanidad. Conclusiones: La presencia de blefaroptosis es un reto diagnóstico, ya que puede ser originada al menos por un centenar de causas.

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