Bilateral ptosis following wasp sting.

We report a case of bilateral ptosis due to wasp sting which was completely treatable. and neck, pulse was 100/min, BP was 120/80 mm of Hg and cyanosis, clubbing, pedal edema and jaundice were absent. Respiratory system, cardiovascular system and abdomen revealed no detectable clinical abnormality. Examination of central nervous system showed bilateral ptosis (Fig. 1a) and nasal tone of voice, otherwise this system was also clinically normal with no other focal neurological signs. Patient was treated by intravenous antibiotic, analgestic and IV fluids. In addition intravenous neostigmine was given in the dose of 1 amp IV every 30 minutes to combat the ptosis. To counter the nicotinic effect of neostigmine, atropine was given (1 amp for every 4 amps of neostigmine). Local and systemic manifestations including neuroparalytic manifestation (nasal tone of voice, inability to see and inability to swallow) disappeared after 24-36 hours. A very gradual recovery was noted in ptosis that completely disappeared on 15.7.2002, (Fig. 1b) patient was discharged asymptomatic on 16.7.2002.