--- title: What's Your Medical Diagnosis? 90y, Female, unilateral ptosis description: "Test your medical diagnosis skills with an NEJM case: 90y female, unilateral ptosis. Get diagnosis assistance with Isabel." image: https://info.isabelhealthcare.com/hs-fs/file-17422300-jpg/images/images-1-resized-600.jpg --- March 19, 2012 # What's Your Medical Diagnosis? 90y, Female, unilateral ptosis The [Isabel](https://info.isabelhealthcare.com/blog/demo-request/) tool touts an extensive database of conditions for differential diagnosis support, and we often will test its accuracy with real patient cases from the New England Journal of Medicine. ## About the Isabel Diagnosis Challenge The [**New England Journal of Medicine**](http://content.nejm.org/) (NEJM) publishes interesting presentations of common diseases and unusual cases in the Clinical pathology Conference (CPC) series. These cases are educational and can pose diagnostic challenges even to the expert physicians at the Massachusetts General Hospital. [![New England Journal of Medicine](https://info.isabelhealthcare.com/hs-fs/file-17422300-jpg/images/images-1-resized-600.jpg?width=48&height=48&name=images-1-resized-600.jpg)](http://nejm.org/)Using the clinical features of these cases you can evaluate your own diagnostic skills and compare your diagnostic performance to that of the physicians at MGH. If you are registered with Isabel as a client or have a free-trial subscription, you can use the diagnosis reminder system and run through some scenarios to get a list of likely suspects. Clicking on a diagnosis will take you through to various knowledge sources and links available from within Isabel. ## Today's Case Demographic: Female, 90 yrs, North America Clinical features: - ptosis - high white cell count - dysphagia - hoarseness - general fatigue - dysarthria - head drop - respiratory failure - mediastinal widening **STOP !** **Before you read further, construct your own:** - Complete differential diagnosis - Final diagnosis **Differential Diagnoses considered by the MGH panel:** Cavernous carotid aneurysm **Final Diagnosis of the case according to NEJM:** (i) Thymoma (ii)Paraneoplastic myasthenia gravis **Differential Diagnoses of the case as given by Isabel:** Cavernous carotid aneurysm under Arterial aneurysms in Vascular **Was the final diagnosis given by Isabel:** Yes. 1) Thymoma under Thymic Neoplasms in Respiratory and 2) Myasthenia Gravis in Neuromuscular [![NEJM case 39](https://info.isabelhealthcare.com/hs-fs/file-17419590-gif/images/case_39-resized-600.gif)](https://info.isabelhealthcare.com/demo-request/)                             Full case: [NEJM case 39 ](http://www.nejm.org/doi/full/10.1056/NEJMcpc1110048) [![Click me](https://no-cache.hubspot.com/cta/default/133692/abbb90a2-5e62-4709-835c-4e95fd434a0b.png)](https://cta-redirect.hubspot.com/cta/redirect/133692/abbb90a2-5e62-4709-835c-4e95fd434a0b) [![Share on Facebook](https://static.hubspot.com/final/img/common/icons/social/facebook-24x24.png)](http://www.facebook.com/share.php?u=https%3A%2F%2Finfo.isabelhealthcare.com%2Fblog%2Fmedical-diagnosis-unilateral-ptosis%3Futm_medium%3Dsocial%26utm_source%3Dfacebook) [![Share on LinkedIn](https://static.hubspot.com/final/img/common/icons/social/linkedin-24x24.png)](http://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Finfo.isabelhealthcare.com%2Fblog%2Fmedical-diagnosis-unilateral-ptosis%3Futm_medium%3Dsocial%26utm_source%3Dlinkedin) [![Share on Twitter](https://static.hubspot.com/final/img/common/icons/social/twitter-24x24.png)](https://twitter.com/intent/tweet?original_referer=https%3A%2F%2Finfo.isabelhealthcare.com%2Fblog%2Fmedical-diagnosis-unilateral-ptosis%3Futm_medium%3Dsocial%26utm_source%3Dtwitter&url=https%3A%2F%2Finfo.isabelhealthcare.com%2Fblog%2Fmedical-diagnosis-unilateral-ptosis%3Futm_medium%3Dsocial%26utm_source%3Dtwitter&source=tweetbutton&text=What%27s%20Your%20Medical%20Diagnosis%3F%2090y%2C%20Female%2C%20unilateral%20ptosis) ### Subscribe Here! ### Recent Posts ### [Meningococcal Infections: The Ongoing Need for Early Diagnosis in the UK (2026 Update)](https://info.isabelhealthcare.com/blog/meningococcal-infections-the-ongoing-need-for-early-diagnosis-in-the-uk-2026-update) Meningococcal infections (including meningococcal meningitis, meningococcal septicaemia, and.. ### [Isabel DDx Companion with ChatGPT Integration - 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