78 results match your criteria: "Apraxia of Lid Opening"

Frontalis muscle flap eyelid reanimation technique in adults with severe ptosis or apraxia of eyelid opening.

Orbit

July 2024

Ophthalmology, Kahana Oculoplastic and Orbital Surgery, Livonia, Michigan, USA.

Purpose: Assessment of the frontalis muscle flap eyelid reanimation surgical technique for adults with severe ptosis and apraxia of eyelid opening.

Methods: A retrospective case series of 30 eyes with severe ptosis or apraxia of eyelid opening. Outcomes were assessed for margin to reflex distance 1 (MRD1), lagophthalmos, complications, and need for subsequent surgical intervention.

View Article and Find Full Text PDF

Apraxia of eyelid opening (AEO) is occasionally seen in Parkinson's disease (PD) or related diseases. However, many clinicians have trouble with the management of AEO by Parkinsonism. In this report, we describe a case of AEO in Parkinsonism improved by trihexyphenidyl (THP).

View Article and Find Full Text PDF

Blepharospasm Secondary to Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson Disease: Clinical Characteristics and Management Outcomes.

J Neuroophthalmol

December 2023

Oculoplastic Department, (MAT, AIM, ES-A, ERC, DGE), Moorfields Eye Hospital, London, United Kingdom; Department of Neuro-ophthalmology (ML, ERC), National Hospital for Neurology and Neurosurgery, London, United Kingdom; Department of Neurology (PB), Addenbrooke's Hospital, Cambridge, United Kingdom; and UCL Institute of Ophthalmology NIHR, Department of Biomedical Research Centre for Ophthalmology (DGE), London, United Kingdom.

Article Synopsis
  • Deep brain stimulation (DBS) of the subthalamic nucleus can help patients with Parkinson's but can also lead to problems like blepharospasm and apraxia of eyelid opening (ALO).
  • This study documented the experiences of five patients suffering from these issues after receiving STN-DBS, focusing on their treatments and symptom management from 2011 to 2020.
  • Results showed that a personalized treatment plan, including options like botulinum toxin injections and various surgical procedures, led to significant improvements in their eyelid movement disorders.
View Article and Find Full Text PDF

Apraxia of lid opening in multiple sclerosis.

Can J Ophthalmol

June 2023

Blanton Eye Institute, Houston Methodist Hospital, Houston, TX; Weill Cornell Medicine, New York, NY; University of Texas Medical Branch, Galveston, TX; University of Texas MD Anderson Cancer Center, Houston, TX; Texas A&M College of Medicine, Bryan, TX; University of Iowa Hospitals and Clinics, Iowa City, IA. Electronic address:

View Article and Find Full Text PDF

Purpose: To report a case of unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye of a patient with Parkinson-plus syndrome.

Observations: A 67-year-old-man who was a known case of Parkinson-plus syndrome on long-term dopamine agonists and anti-psychotic medications demonstrated apraxia of lid opening associated with moderate-to-severe blepharospasm. He had unilateral posterior dislocation of the cataractous lens and subluxation of the lens in the fellow eye with no prior history of trauma or other known ocular risk factors.

View Article and Find Full Text PDF

Macaque monkey trigeminal blink reflex circuits targeting levator palpebrae superioris motoneurons.

J Comp Neurol

October 2021

Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA.

For normal viewing, the eyes are held open by the tonic actions of the levator palpebrae superioris (levator) muscle raising the upper eyelid. This activity is interrupted during blinks, when the eyelid sweeps down to spread the tear film or protect the cornea. We examined the circuit connecting the principal trigeminal nucleus to the levator motoneurons by use of both anterograde and retrograde tracers in macaque monkeys.

View Article and Find Full Text PDF

Background: New-onset apraxia of lid opening (ALO) is reported to occur in Parkinson's disease (PD) patients following Deep Brain Stimulation (DBS). There are only few systematic studies on this uncommon disorder of eyelid movements.

Objectives: We aimed to examine the frequency, temporal evolution, predisposing factors and response to treatment, of new-onset ALO in PD patients who underwent bilateral subthalamic nucleus (STN) DBS.

View Article and Find Full Text PDF

Background: Full myectomy is recommended for benign essential blepharospasm (BEB) refractory to botulinum toxin (BT) treatment, but long-term swelling, scar contracture, hollow appearance, and unnatural contour of the eyelids are common postoperative complications. We present myotomy in situ to minimize these adverse outcomes.

Methods: The redundant eyelid skin with its underlying muscle is resected first, and myotomy in situ is performed by completely cutting the residual orbicularis oculi muscles into multiple cubes and down to the subcutaneous layer, and then cutting the procerus and corrugator muscles down to the periosteum.

View Article and Find Full Text PDF

Mini-incisional entropion repair for correcting involutional entropion: Full description and surgical outcome.

Medicine (Baltimore)

August 2019

Department of Ophthalmology, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.

The aim of the study was to report the surgical outcome of mini-incisional correction method to treat involutional entropion.This is a retrospective interventional case series of 46 eyelids in 31 patients with involutional entropion and significant ocular irritation. In this technique, after turning the lower eyelid inside out, threads are introduced into it through the conjunctiva close to the inferior fornix.

View Article and Find Full Text PDF

A 37-year-old female presented with severe apraxia of lid opening (ALO) affecting the right upper lid associated with Becker congenital myotonia (MC). The patient had a history of right upper lid ptosis for 25 years that was exacerbated over the previous month with severe incapacity to open her right eye. No other associated neurological or ophthalmic symptoms were observed.

View Article and Find Full Text PDF

I-FP-CIT SPECT imaging in blepharospasm.

Rev Neurol (Paris)

December 2017

Neurology, CHU Caremeau, place du Professeur-Debré, 30000 Nîmes, France.

Introduction: Blepharospasm is a focal dystonia characterized by involuntary cocontraction of the eyelid protractors, causing spasmodic closure of the eyelids. Apraxia of eyelid opening is caused by an inability to initiate lid opening without paralytic abnormality. Some studies suggest that patients with either pure blepharospasm or blepharospasm associated with apraxia of eyelid opening are more prone to developing Parkinson's disease.

View Article and Find Full Text PDF

Blepharospasm may be accompanied by eyelid opening apraxia (EOA) reducing the efficacy of botulinum toxin (BT) therapy. The frontalis suspension operation (FSO) is then the only effective treatment option available. We want to report the first long-term results with FSO.

View Article and Find Full Text PDF

Bilateral ptosis: Lesion in the oculomotor nuclei or supranuclear lesion?

NeuroRehabilitation

May 2016

Département des Neurosciences cliniques, Unité de Neuro-Réhabilitation Aigüe, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Background: Bilateral ptosis is a very interesting clinical challenge for doctors because of the multiple possible localizations of a lesion which can lead to this neurological sign.

Objectives: Through this case report, we aim to determine the difference between an apraxia of lid opening (ALO) with difficulty in initiating the act of lid elevation, in spite of adequate understanding, motor control and cranial nerve pathways, and a bilateral ptosis with a lesion in the oculomotor nucleus or blepharospasm.

Methods: The case report of a 50-year-old patient presenting bilateral ptosis and multiple ischemic lesions in the brainstem and bilateral frontal lobe lesions after the emergency removal of a large frontal tumor.

View Article and Find Full Text PDF

Introduction: We describe the results of 15 patients suffering from essential blepharospasm with apraxia of eyelid opening who underwent frontalis suspension surgery.

Material And Methods: Patients with apraxia of eyelid opening and unresponsive to botulinum toxin injections were studied. Bilateral frontalis suspension surgery was performed (sling operation) using polytetrafluoroethylene (Gore-Tex®) sutures.

View Article and Find Full Text PDF

Blepharospasm is seen in many cases of Parkinsonism including progressive supranuclear palsy. These patients usually respond well to botulinum toxin, however some patients subsequently fail to respond to even higher doses of botulinum toxin after an initial good response. They should not be considered failure of treatment with botulinum toxin, as a significant number of these patients have underlying apraxia of eyelid opening in addition to blepharospasm, which may be the cause of failure to respond to botulinum toxin.

View Article and Find Full Text PDF

Apraxia of lid opening (ALO) is a non-paralytic inability to open the eyes or sustain lid elevation at will. The exact pathophysiological mechanisms underlying the syndrome are still unknown. ALO has been reported in patients with Parkinson's disease (PD) after subthalamic nucleus (STN) deep brain stimulation (DBS), suggesting a possible involvement of the basal ganglia.

View Article and Find Full Text PDF

Dystonia is defined as a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements, or abnormal postures. Its diagnosis is based on clinical characteristics. In dystonia, the pattern of abnormal posture or movement tends to be constant during the short term even if its severity fluctuates.

View Article and Find Full Text PDF

Normal and abnormal lid function.

Handb Clin Neurol

August 2011

Departments of Neurology and Ophthalmology, The Mount Sinai Medical Center, New York, NY 10029, USA.

This chapter on lid function is comprised of two primary sections, the first on normal eyelid anatomy, neurological innervation, and physiology, and the second on abnormal eyelid function in disease states. The eyelids serve several important ocular functions, the primary objectives of which are protection of the anterior globe from injury and maintenance of the ocular tear film. Typical eyelid behaviors to perform these functions include blinking (voluntary, spontaneous, or reflexive), voluntary eye closure (gentle or forced), partial lid lowering during squinting, normal lid retraction during emotional states such as surprise or fear (startle reflex), and coordination of lid movements with vertical eye movements for maximal eye protection.

View Article and Find Full Text PDF

Blinking and opening/closing of the eyelid are considered to be different movements with independent control mechanisms. Apraxia of lid opening (ALO) is a clinical syndrome in which patients experience difficulty in opening their eyes voluntarily. Our previous study with fluorodeoxyglucose and positron emission tomography (PET) has suggested that functional impairments in the supplementary motor area (SMA) and the anterior cingulate gyrus may be involved in the pathophysiology of ALO.

View Article and Find Full Text PDF

Visual signs and symptoms of progressive supranuclear palsy.

Clin Exp Optom

March 2011

Vision Sciences, Aston University, Birmingham, United Kingdom.

Progressive supranuclear palsy is a rare, degenerative brain disorder and the second most common syndrome in which the patient exhibits 'parkinsonism', that is, a variety of symptoms involving problems with movement. General symptoms include difficulties with gait and balance; the patient walking clumsily and often falling backwards. The syndrome can be difficult to diagnose and visual signs and symptoms can help to separate it from closely related movement disorders such as Parkinson's disease, multiple system atrophy, dementia with Lewy bodies and corticobasal degeneration.

View Article and Find Full Text PDF

Involuntary eyelid closure after STN-DBS: evidence for different pathophysiological entities.

J Neurol Neurosurg Psychiatry

September 2010

Center of Neurology, Hertie Institute for Clinical Brain Research, and German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany.

Objective: Involuntary eyelid closure (IEC) may occur after deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson's disease (PD) and is often categorised as apraxia of lid opening (ALO), albeit the appropriateness of this term is under debate. To gain insight into the hitherto undefined pathophysiology of IEC after STN-DBS, we performed a comprehensive clinical and electrophysiological characterisation of lid function in a total of six PD patients.

Methods: The study was carried out in six PD patients who developed IEC after STN-DBS.

View Article and Find Full Text PDF