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Bell's Palsy-associated blepharospasm relieved by aiding eyelid closure
J C Chuke1, R S Baker, J D Porter
1Department of Ophthalmology, University of Kentucky Medical Center, Lexington, KY 40536-0284, USA.
Annals of Neurology
|February 1, 1996
Summary
Adaptive mechanisms maintain blink reflex efficacy. In a rare case, eyelid spasms contralateral to facial nerve palsy resolved after a gold weight aided eyelid closure, suggesting reduced reflex excitability.
Area of Science:
- Neuroscience
- Ophthalmology
Background:
- The blink reflex is crucial for ocular protection and is regulated by complex adaptive control mechanisms.
- Facial nerve palsy can impair eyelid function, potentially leading to secondary complications.
Observation:
- A 39-year-old woman presented with blepharospasm-like symptoms on the side opposite to her facial nerve palsy affecting eyelid closure.
- This paradoxical hyperexcitability of the blink reflex was observed without the expected changes in the main sequence slope.
Findings:
- Surgical implantation of a gold weight to assist closure of the paretic eyelid successfully eliminated the eyelid spasms.
- This intervention suggests that aiding eyelid closure reduced blink system excitability, likely through the same adaptive mechanisms that initially caused the spasm.
Implications:
- The findings indicate that blink-adaptive systems may regulate reflex excitability and main sequence relationships, potentially independently or synergistically.
- This case highlights a novel therapeutic approach for managing unusual blink reflex abnormalities secondary to facial nerve palsy.