Apraxia of eyelid opening after subthalamic deep brain stimulation may be caused by reduction of levodopa

Umemura, Atsushi; Toyoda, T.; Oka, Yuichi; Ishii, Fumiyasu; Yamada, Kazuo

doi:10.1016/j.parkreldis.2007.12.008

Cited by 25 publications

(18 citation statements)

References 9 publications

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“…Aripiprazole is a unique antipsychotic classified under dopamine system stabilizers (11). Some reports have demonstrated the efficacy of levodopa or serotonin reuptake inhibitors for AEO (12)(13)(14). The mechanism whereby aripiprazole improves AEO is unknown, however, it may act on the dopaminergic or serotoninergic systems.…”

Section: Discussionmentioning

confidence: 99%

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

et al. 2015

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We herein report three cases of Parkinson's disease associated with difficulty in eyelid opening, referred to as apraxia of eyelid opening (AEO), which improved after aripiprazole treatment. In case 1, aripiprazole was administered as a psychiatric treatment. It proved to be effective in AEO with blepharospasm. In case 2 and case 3, the patients experienced AEO without blepharospasm, and a significant improvement was observed after aripiprazole treatment. In this study, the aripiprazole dosage ranged between 3 and 9 mg/day. This is the first report of aripiprazole as a potentially effective treatment for AEO in Parkinson's disease.

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Section: Discussionmentioning

confidence: 99%

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

et al. 2015

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“…From our experience, postoperative modification of dopaminergic medication may be a cause of ALO in the early period after surgery. 26) Newly developed back pain or deterioration of preexisting back pain sometimes occurs after STN-DBS in patients with lumbar spine pathologies. Increased motor activity after STN-DBS may lead to the development of back pain, which had been masked by the immobility of PD before surgery.…”

Section: Discussionmentioning

confidence: 99%

Complications of Subthalamic Nucleus Stimulation in Parkinson's Disease

Umemura

Oka

Yamamoto

et al. 2011

Neurol. Med. Chir.(Tokyo)

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Subthalamic nucleus deep brain stimulation (STN-DBS) is effective for medically refractory Parkinson's disease. We retrospectively analyzed complications in 180 consecutive patients who underwent bilateral STN-DBS. Surgery-related complications were symptomatic intracerebral hemorrhage in 2, chronic subdural hematoma in 1, and transient deterioration of medication-induced psychosis in 2 patients. Device-related complications involved device infection in 5, skin erosion in 5, and implantable pulse generator malfunction in 2 patients. All of these patients required surgical repair. Surgery and device-related complications could be reduced with increased surgical experience and the introduction of new surgical equipment and technology. Treatment or stimulation-related complications were intractable dyskinesia/dystonia in 11, problematic dysarthria in 7, apraxia of eyelid opening (ALO) in 11, back pain in 10, and restless leg syndrome in 6 patients. Neuropsychiatric complications were transient mood changes in some, impulse control disorder in 2, severe depression related to excessive reduction of dopaminergic medications in 2, rapid progression of dementia in 1, and suicide attempts in 2 patients. Most complications were mild and transient. Dysarthria and ALO were the most frequent permanent sequelae after STN-DBS. Treatment-related adverse events may be caused not only by the effect of stimulation effect but also excessive reduction of dopaminergic medication, or progression of the disease. In conclusion, STN-DBS seems to be a relatively safe procedure. Although serious complications with permanent sequelae are rare, significant incidences of adverse effects occur. Physicians engaged in this treatment should have a comprehensive understanding of the probable complications and how to avoid them.

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“…In fact, experimental low-frequency stimulation of the STN at certain voltage thresholds has been shown to induce myoclonus in the pretarsal OO (149). The weaning of levodopa following DBS may also unmask pre-existing symptoms (150). AEO usually occurs within a year of DBS implantation.…”

Section: Apraxia Of Eyelid Opening and Closurementioning

confidence: 99%

Eyelid Dysfunction in Neurodegenerative, Neurogenetic, and Neurometabolic Disease

Hamedani

Gold

2017

Front. Neurol.

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Eye movement abnormalities are among the earliest clinical manifestations of inherited and acquired neurodegenerative diseases and play an integral role in their diagnosis. Eyelid movement is neuroanatomically linked to eye movement, and thus eyelid dysfunction can also be a distinguishing feature of neurodegenerative disease and complements eye movement abnormalities in helping us to understand their pathophysiology. In this review, we summarize the various eyelid abnormalities that can occur in neurodegenerative, neurogenetic, and neurometabolic diseases. We discuss eyelid disorders, such as ptosis, eyelid retraction, abnormal spontaneous and reflexive blinking, blepharospasm, and eyelid apraxia in the context of the neuroanatomic pathways that are affected. We also review the literature regarding the prevalence of eyelid abnormalities in different neurologic diseases as well as treatment strategies (Table 1).

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Apraxia of eyelid opening after subthalamic deep brain stimulation may be caused by reduction of levodopa

Cited by 25 publications

References 9 publications

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

Complications of Subthalamic Nucleus Stimulation in Parkinson's Disease

Eyelid Dysfunction in Neurodegenerative, Neurogenetic, and Neurometabolic Disease

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