[Asynchronous Bell's phenomenon in progressive supranuclear palsy]

A 60-year-old man suffering from progressive supranuclear palsy showed asynchronous Bell's phenomenon and apraxia of eye-lid opening. He showed synchronous upward rotation of the eyeball at closing eyes. Although apraxia of eye-lid opening was observed in both sides, eye opening of the right side took longer duration than that of the opposite side. When he tried to open his eyes, unilateral Bell's phenomenon was sustained in the side of involuntary eye closing for a several seconds. These findings indicated disorders of the coordination of eye opening-and-closing, which regulate the orbicural muscle of eye, levator muscle of upper eyelid and external ocular muscles. And the mechanism of synchronous eye movement between the both sides was also disturbed. The administration of L-droxydopa was effective to gait disturbance, but not to ocular movement disorder including impaired Bell's phenomenon. The pharmacological results suggested different neuron system between locomotion control and conjugation affected in this disease.