The undesirable wink.

Area of Science:

• Ophthalmology
• Neurology
• Facial Nerve Disorders

Background:

• Marin-Amat syndrome is a rare acquired oculofacial synkinesis.
• It manifests as involuntary eyelid closure linked to jaw movements after peripheral facial nerve palsy.
• Aberrant connections between cranial nerves V and VII cause increased orbicularis tone, leading to psychosocial distress.

Purpose of the Study:

• To raise awareness about the management of Marin-Amat syndrome.
• To highlight various treatment modalities for this rare condition.

Main Methods:

• Presentation of six patient cases with Marin-Amat syndrome.
• Clinical assessment including margin reflex distance (MRD) measurements.
• Review of management options: observation, botulinum toxin injection, and surgical intervention (orbicularis resection and blepharoplasty).

Main Results:

• Four of six patients chose observation.
• One patient received botulinum toxin injection.
• One patient underwent orbicularis resection and blepharoplasty, with satisfactory reduction in synkinetic movement for both treated patients.

Conclusions:

• Marin-Amat syndrome is a rare, often underdiagnosed disorder following peripheral facial nerve palsy.
• Botulinum toxin injection and preseptal orbicularis resection are effective management options.
• Management strategies should be tailored to individual patient needs and preferences.