Bilateral medial rectus-levator inhibitory synkinesis: a case report and review of literature
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Updated: Jul 8, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Mostafa M Diab1,2,3
1Department of Ophthalmology, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt.
Abstract:
Congenital oculopalpebral synkinesis is a rare phenomenon in which specific ocular movements induce paradoxical eyelid responses. Most reported cases involve excitatory forms, whereas inhibitory variants are distinctly uncommon. We present a 15-year-old boy with congenital right ptosis who demonstrated bilateral gaze-evoked synkinetic eyelid movements. In addition, paradoxical right upper lid retraction was observed on downgaze, and vertical lid twitching was evident in upgaze and lateral gazes. Ocular motility and pupillary reactions were normal, and no jaw-winking was present.
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