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[Asynchronous Bell's phenomenon in progressive supranuclear palsy]

M Konagaya1, M Iida

  • 1Department of Neurology, Suzuka National Hospital, Mie, Japan.

No to Shinkei = Brain and Nerve
|August 1, 1993
PubMed
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This study details a progressive supranuclear palsy patient with eye movement coordination issues, including asynchronous Bell's phenomenon and eyelid opening apraxia. L-droxydopa improved gait but not ocular deficits, suggesting distinct neural pathways.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Neurology

Background:

  • Progressive supranuclear palsy (PSP) is a neurodegenerative disease affecting eye movement control.
  • Understanding the specific ocular motor deficits in PSP is crucial for diagnosis and management.

Observation:

  • A 60-year-old male patient with PSP presented with asynchronous Bell's phenomenon and bilateral eyelid opening apraxia.
  • Synchronous upward eyeball rotation occurred during eye closure.
  • Delayed eye opening was noted on the right side, with sustained unilateral Bell's phenomenon during attempted eye opening.

Findings:

  • The observed symptoms indicate disrupted coordination of eye opening/closing mechanisms involving orbicularis oculi, levator palpebrae superioris, and extraocular muscles.
  • Impaired mechanisms for synchronous bilateral eye movements were evident.

Related Experiment Videos

  • L-droxydopa treatment effectively addressed gait disturbances but showed no benefit for the ocular movement disorder, including Bell's phenomenon.

    • Implications:

    • These findings suggest distinct neural systems govern locomotion control and conjugate eye movements in PSP.
    • The differential response to L-droxydopa highlights the complexity of PSP pathophysiology.
    • Further research into targeted therapies for PSP-related ocular motor dysfunction is warranted.