Premium
Bell's palsy–associated blepharospasm relieved by aiding eyelid closure
Author(s) -
Chuke John C.,
Baker Robert S.,
Porter John D.
Publication year - 1996
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410390217
Subject(s) - eyelid , corneal reflex , blepharospasm , reflex , palsy , eyelid diseases , psychology , supraorbital nerve , facial nerve , medicine , anesthesia , surgery , neuroscience , dystonia , pathology , alternative medicine
The efficacy of the blink reflex is maintained by adaptive control mechanisms. We describe a 39‐year‐old woman with the rare complication of blepharospasm‐like symptoms appearing contralateral to an eyelid weakened by facial nerve palsy. The hyperexcitable blink reflex may be a maladaptive consequence of adaptive systems but was not accompanied by an expected increase in main sequence slope. Eyelid spasms were eliminated by the implantation of a gold weight to assist closure of the paretic eyelid. We suggest that aiding closure of the weak eyelid in this case caused a reduction in blink system excitability via the same compensatory mechanisms that initially produced the eyelid spasm. Data also suggest that blinkadaptive systems act via changes in reflex excitability and/or main sequence relationships, and that these may be regulated either synergistically or independent of one another.