Eyelid closing and opening disorders in patients with unilateral brain lesions: A case report with video neuroimage and a systematic review of the literature

Nicoletti, Tommaso; Quaranta, Davide; Marca, Giacomo Della; Tasca, Giorgio; Gainotti, Guido

doi:10.1016/j.jocn.2021.02.020

Cited by 3 publications

(3 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 16 ] Table 1 presents a comparison between the clinical findings of the study and those reported in the literature. [ 2 10 11 12 17 18 ] In this study, however, we emphasized the ability to notice such uncommon features such as AECs by the care-providing team, family members, and those who take care of patients, which can be valuable information to reach a correct diagnosis and facilitate optimal treatment and early referral. PSP and PD diagnosis can be challenging especially in the early course of the disease.…”

Section: Discussionmentioning

confidence: 99%

The important role of family members in guiding medical professions to reach a diagnosis: Case report of under-noticed bilateral apraxia of eyelid closure

Alyazidi

Alnajashi

2023

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Apraxia of eyelid closure (AEC) is a rare disorder characterized by the inability to close the eyes on command with the preservation of the motor and sensory systems, coordination, comprehension, and cooperation. The prevalence of AEC is extremely small and the exact pathophysiological mechanisms underlying this condition remain unknown. It is, however, associated with extrapyramidal disorders. Very few cases of bilateral AEC have been reported. We report a case of an 81-year-old male patient having multiple comorbidities including neurological, respiratory, and abnormalities complicated by COVID-19 infection, who developed AEC that was noticed by the caregiver. We illustrate the clinical course leading to the diagnosis of bilateral AEC and highlight the important role of the caregiver in reporting subtle signs such as AEC.

show abstract

Section: Discussionmentioning

confidence: 99%

The important role of family members in guiding medical professions to reach a diagnosis: Case report of under-noticed bilateral apraxia of eyelid closure

Alyazidi

Alnajashi

2023

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

show abstract

“…These patients were excluded from the present study because recent data suggest that these 2 allegedly apraxic disorders of eyelid opening (scAEO) and closure (AEC) are quite distinct and may not share the same pathophysiological mechanisms or neural substrates. 51…”

Section: Methodsmentioning

confidence: 99%

Debunking the Puzzle of Eyelid Apraxia: The Muscle of Riolan Hypothesis

Tawfik

Dutton

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Apraxia of eyelid opening (AEO) has been defined by the presence of an intermittent nonparalytic bilateral loss of the volitional ability to open the eyes or to maintain the eyelids in a sustained elevated position. It is not known whether the condition represents an apraxia, a dystonia, or a freezing phenomenon, and several different nomenclatorial terms have been suggested for this condition including the so-called AEO (scAEO), blepahrocolysis, focal eyelid dystonia, and so on. The primary goal of this review is to attempt to clarify the pathogenetic mechanisms underlying scAEO as a clinical phenomenon. This review also addresses the issue of whether scAEO is part of the spectrum of blepharospasm (BSP) which includes BSP, dystonic blinks and other dystonic eyelid conditions, or whether it is a separate phenomenologically heterogeneous disease with clinical features that merely overlap with BSP.Methods: A literature review was conducted in PubMed, MEDLINE, PubMed Central (PMC), NCBI Bookshelf, and Embase for several related keywords including the terms "apraxia of eyelid opening," "pretarsal blepharospasm," "blepharocolysis," "eyelid freezing," "eyelid akinesia," "levator inhibition," "blepharospasm-plus," as well as "blepharospasm." The clinical findings in patients with scAEO who fulfilled the classic diagnostic criteria of the disease that were originally set by Lepore and Duvoisin were included, while patients with isolated blepharospasm or dystonic blinks (DB) were excluded. In addition, electromyographic (EMG) studies in patients with scAEO were reviewed in detail with special emphasis on studies that performed synchronous EMG recordings both from the levator muscle (LPS) and the pretarsal orbicularis oculi muscle (OO).Results: The apraxia designation is clearly a misnomer. Although scAEO behaves clinically as a hypotonic freezing phenomenon, it also shares several cardinal features with focal dystonias. The authors broadly categorized the EMG data into 3 different patterns. The first pattern (n = 26/94 [27.6%]) was predominantly associated with involuntary discharges in the OO muscle and has been termed pretarsal blepharospasm (ptBSP). The commonest pattern was pattern no. 2 (n = 53/94 [56.38%]), which was characterized by involuntary discharges in the OO muscle, together with a disturbed reciprocal innervation of the antagonist levator muscle and is dubbed disturbed reciprocal innervation (DRI). This EMG pattern is difficult to discern from the first pattern. Pattern no. 3 (n = 15/94 [15.9%]) is characterized by an isolated levator palpebrae inhibition (ILPI). This levator silence was observed alone without EMG evidence of contractions in the pretarsal orbicularis or a disturbed reciprocal relation of both muscles.Conclusion: EMG evidence shows that the great majority (84%) of patients show a dystonic pattern, whereas ILPI (16%) does not fit the dystonic spectrum. The authors propose that a spasmodic contraction of the muscle of Riolan may be the etiological basis for levator inhibition in patients with ...

show abstract

“…Which hemisphere is dominant in supranuclear control of eyelid movements is a matter of debate. In a systematic review, Nicoletti et al described that all 15 patients with unilateral AEC had contralateral lesions, that is, a right hemisphere lesion, whereas a similar hemispheric lesion was observed in 90% (17/19) of patients with bilateral AEC [3]. They also mentioned that, in contrast to apraxia of eyelid opening, where subcortical structures are commonly affected, the frontoparietal cortex is predominantly involved in AEC.…”

Section: A B Cmentioning

confidence: 99%

Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report

et al. 2021

View full text Add to dashboard Cite

BackgroundFor certain ocular movement abnormalities, the exact neuroanatomical localization of the causative lesion is still not defined. Oculomotor apraxia, apraxia of eye opening and closing, and motor impersistence are rarely reported in acute stroke, particularly following venous stroke.Case ReportA 34-year-old man presented with headache, vomiting, focal seizures with bilateral tonic-clonic movements, and altered sensorium. Magnetic resonance imaging revealed bilateral frontal and left parietal hemorrhagic infarcts, and contrast venography revealed superior sagittal sinus thrombosis. The patient received anticoagulant treatment with antiepileptics. On re-examination on day 3, the patient had a rare combination of apraxia of eyelid closure, motor impersistence, and oculomotor apraxia. By Day 10 of admission, all oculomotor abnormalities had subsided.ConclusionTo the best of our knowledge, this is the first report of the combination of oculomotor apraxia and apraxia of eyelid closure with motor impersistence in a patient with cerebral venous sinus thrombosis.

show abstract

Eyelid closing and opening disorders in patients with unilateral brain lesions: A case report with video neuroimage and a systematic review of the literature

Cited by 3 publications

References 35 publications

The important role of family members in guiding medical professions to reach a diagnosis: Case report of under-noticed bilateral apraxia of eyelid closure

The important role of family members in guiding medical professions to reach a diagnosis: Case report of under-noticed bilateral apraxia of eyelid closure

Debunking the Puzzle of Eyelid Apraxia: The Muscle of Riolan Hypothesis

Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report

Contact Info

Product

Resources

About