Neurologic and Muscular Lid Disorders

Question 1

Blepharospasm

Answer 1

• bilateral involuntary obicularis spasm
• occurs more in females; 6th decade of life
• can be treated with BOTOX if debilitating to reduce muscle response

Question 2

Blepharoclonus

Answer 2

• excessive blinking with subsequent spasm, until complete spasm shut
• secondary to ocular inflammation; treat the inflammation to treat blepharaclonus

Question 3

Myokymia

Answer 3

• fasciculation/twitching of obicularis
• unilateral, self-limiting
• “jumping/quivering of lid or lid”
• associated with fatigue, stress, meds, alcohol
• tear: cold compress, antihistamines, tonic water (quinine), increase refrac. period

Question 4

Pseudograefe

Answer 4

• aberrant regeneration due to 3rd nerve trauma (where MR runs to levator)
• causes elevation of eye when adducted (up and in)

Question 5

Marcus Gunn Phenomenon

jaw winking

Answer 5

• seen in 5% of congenital ptosis patients
• patient ptosis improved with open mouth
• treat with surgery