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Sleep-Induced Apraxia of Eyelid Opening
Sara N Reggie1, John J Chen, Michael S Lee
1Department of Ophthalmology (SNR, SMC), Saint Louis University, Saint Louis, Missouri; Department of Ophthalmology (JJC), Mayo Clinic, Rochester, Minnesota; and Department of Ophthalmology (MSL), University of Minnesota, Minneapolis, Minnesota.
Summary
Apraxia of eyelid opening (AEO) on awakening is rare. This study found it can occur unilaterally or bilaterally in Caucasian women, sometimes linked to autoimmune disease, and typically resolves after manual eyelid elevation.
Area of Science:
- Neuro-ophthalmology
- Neurology
Background:
- Apraxia of eyelid opening (AEO) is typically bilateral, linked to neurodegenerative diseases.
- Rarely, AEO can be isolated, idiopathic, or unilateral upon waking.
Purpose of the Study:
- To describe an unusual variation of AEO occurring exclusively upon awakening from sleep.
- To characterize the clinical presentation and potential associations of this AEO subtype.
Main Methods:
- Retrospective, observational case series.
- Data collected from 11 patients across 3 neuro-ophthalmology practices.
Main Results:
- 11 Caucasian women (mean age 59) presented with AEO upon waking.
- 8 had unilateral AEO, 3 bilateral; 10 required manual eyelid elevation.
- 7 patients had a history of autoimmune disease; ocular and brain imaging were largely unremarkable.
Conclusions:
- AEO exclusively on awakening is a rare condition.
- Neuroimaging and extensive testing are unnecessary without other neurological or ocular findings.
- A potential link to Caucasian females and autoimmune conditions warrants further investigation.