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Eyelid Movements in Facial Paralysis

Eyelid Movements in Facial Paralysis Abstract • We studied the eyelid movements of six patients with unilateral, isolated, facial paralysis using the magnetic search coil. The most significant abnormality consisted of a reduction in the magnitude of the orbicularis oculi contraction with slowing of the peak velocity of the closing phase of the blink. The closing phase blink velocity, which normally increases linearly as a function of amplitude (main sequence), in our patients displayed a relationship characterized by a slow saturating power function that fell off the main sequence. The contralateral normal lid in some cases can show adaptive signs of hyperactivity during the closing phase of the blink. Lid saccades showed a small but consistent decrease in amplitude and velocity compared with the contralateral unaffected eyelid. Unlike the closing phase of the blink, peak velocities of lid saccades stayed on the main sequence. In this study, we discuss how the eyelid executes downward lid saccades based purely on a passive mechanism. References 1. Gordon G. Observations upon the movements of the eyelids . Br J Ophthalmol . 1951;35:339-351.Crossref 2. Bjork A, Kugelberg E. The electrical activity of the muscles of the eye and eyelids in various positions and during movement . Electroencephal Clin Neurophysiol . 1953;5:595-602.Crossref 3. Van Allen MW, Blodi FC. Electromyographic study of reciprocal innervation in blinking . Neurology . 1962;12:371-377.Crossref 4. Esteban A, Salinero E. Reciprocal reflex activity in ocular muscles: implications in spontaneous blinking and Bell's phenomenon . Eur Neurol . 1979;18:157-165.Crossref 5. Becker W, Fuchs AF. Lid-eye coordination during vertical gaze changes in man and monkey . J Neurophysiol . 1988;60:1-26. 6. Evinger C, Shaw MD, Peck CK, Manning KA, Baker R. Blinking and associated eye movements in humans, guinea pigs, and rabbits . J Neurophysiol . 1984;52:323-339. 7. Niida T, Mukuno K, Ishikawa S. Quantitative measurement of upper eyelid movements . Jpn J Ophthalmol . 1987;31:255-264. 8. Kennard DW, Smyth GL. Reflex regulation of the upper eyelids with observations on the onset of sleep . J Physiol . 1963;166:168-177. 9. Kennard DW, Glaser GH. An analysis of eyelid movements . J Nerv Ment Dis . 1964;139:31-48.Crossref 10. Kennard DW, Smyth GL. The causes of downward eyelid movement with changes in gaze and a study of the physical factors concerned . J Physiol (Lond) . 1963;166:168-177. 11. Guitton D, Simard R, Codere F, Beraja R. Upper eyelid movements measured with search coil in magnetic field technique during blinks and vertical saccades. Invest Ophthalmol Vis Sci. In press. 12. Sewall EC. Decompression of the facial nerve . Arch Otolaryngol . 1933;18:746-752.Crossref 13. Collewijn H, Steen JVD, Steinman RM. Human eye movements associated with blinks and prolonged eyelid closure . J Neurophysiol . 1985;54:11-27. 14. Evinger C, Manning KA, Sibony PA. Eyelid movements: mechanisms and normal data . Invest Ophthalmol Vis Sci . 1991;32:387-400. 15. House JW, Brackmann DE. Facial nerve grading system . Otolaryngol Head Neck Surg . 1985;93:146-147. 16. Bahill AT, Clark ME, Stark L. The main sequence: a tool for studying human eye movements . Mathematical Biosci . 1975;24:191-204.Crossref 17. Bjork A. Electromyographic studies on the coordination of antagonistic muscles in cases of abcucens and facial palsy . Br J Ophthalmol . 1954;38:605-615.Crossref 18. Gowers WR. The movements of the eyelids . R Med Chirurg Soc Lond . 1879;62:429-440. 19. Bender MB. The nerve supply to the orbicularis muscle and the physiology of movements of the upper lid with particular reference to the pseudo Graefe phenomena . Arch Ophthalmol . 1936;15:21-30.Crossref 20. Manning KA, Evinger CE, Sibony PA. Eyelid movements before and after botulinum therapy in patients with lid spasms . Ann Neurol . 1990;28:653-660.Crossref 21. Netens A, Smet H. Lid lag in Guillain-Barré-Strohl syndrome . Arch Neurol . 1988;45:1046-1047.Crossref 22. Keane J. Lid lag in Guillain-Barré syndrome . Arch Neurol . 1975;32:478-479.Crossref 23. Anderson RL, Dixon RS. The role of Whitnall's ligament in ptosis surgery . Arch Ophthalmol . 1979;97:705-707.Crossref 24. Anderson RL, Beard C. The levator aponeurosis: attachments and their clinical significance . Arch Ophthalmol . 1977;95:1437-1441.Crossref 25. Hawes MJ, Dortzback RK. The microscopic anatomy of the lower eyelid retractors . Arch Ophthalmol . 1982;100:1313-1318.Crossref 26. Jones LT. The anatomy of the lower eyelid and its relation to the cause and cure of ectropion . Am J Ophthalmol . 1960;49:29-36. 27. Koorneef L. Spatial Aspects of Orbital Musculofibrous Tissue in Man . Amsterdam, the Netherlands: Swets & Zeitimeiger BV; 1977. 28. Sevel D. Ptosis and underaction of the superior rectus muscle . Ophthalmology . 1984;91:1080-1085.Crossref 29. Sevel D. A reappraisal of the origin of human extraocular muscles . Ophthalmology . 1981;88:1330-1338.Crossref 30. Evinger C, Manning KA. A model for motor learning: adaptive gain control of the blink reflex . Exp Brain Res . 1988;70:527-538.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1991.01080110091043
Publisher site
See Article on Publisher Site

Abstract

Abstract • We studied the eyelid movements of six patients with unilateral, isolated, facial paralysis using the magnetic search coil. The most significant abnormality consisted of a reduction in the magnitude of the orbicularis oculi contraction with slowing of the peak velocity of the closing phase of the blink. The closing phase blink velocity, which normally increases linearly as a function of amplitude (main sequence), in our patients displayed a relationship characterized by a slow saturating power function that fell off the main sequence. The contralateral normal lid in some cases can show adaptive signs of hyperactivity during the closing phase of the blink. Lid saccades showed a small but consistent decrease in amplitude and velocity compared with the contralateral unaffected eyelid. Unlike the closing phase of the blink, peak velocities of lid saccades stayed on the main sequence. In this study, we discuss how the eyelid executes downward lid saccades based purely on a passive mechanism. References 1. Gordon G. Observations upon the movements of the eyelids . Br J Ophthalmol . 1951;35:339-351.Crossref 2. Bjork A, Kugelberg E. The electrical activity of the muscles of the eye and eyelids in various positions and during movement . Electroencephal Clin Neurophysiol . 1953;5:595-602.Crossref 3. Van Allen MW, Blodi FC. Electromyographic study of reciprocal innervation in blinking . Neurology . 1962;12:371-377.Crossref 4. Esteban A, Salinero E. Reciprocal reflex activity in ocular muscles: implications in spontaneous blinking and Bell's phenomenon . Eur Neurol . 1979;18:157-165.Crossref 5. Becker W, Fuchs AF. Lid-eye coordination during vertical gaze changes in man and monkey . J Neurophysiol . 1988;60:1-26. 6. Evinger C, Shaw MD, Peck CK, Manning KA, Baker R. Blinking and associated eye movements in humans, guinea pigs, and rabbits . J Neurophysiol . 1984;52:323-339. 7. Niida T, Mukuno K, Ishikawa S. Quantitative measurement of upper eyelid movements . Jpn J Ophthalmol . 1987;31:255-264. 8. Kennard DW, Smyth GL. Reflex regulation of the upper eyelids with observations on the onset of sleep . J Physiol . 1963;166:168-177. 9. Kennard DW, Glaser GH. An analysis of eyelid movements . J Nerv Ment Dis . 1964;139:31-48.Crossref 10. Kennard DW, Smyth GL. The causes of downward eyelid movement with changes in gaze and a study of the physical factors concerned . J Physiol (Lond) . 1963;166:168-177. 11. Guitton D, Simard R, Codere F, Beraja R. Upper eyelid movements measured with search coil in magnetic field technique during blinks and vertical saccades. Invest Ophthalmol Vis Sci. In press. 12. Sewall EC. Decompression of the facial nerve . Arch Otolaryngol . 1933;18:746-752.Crossref 13. Collewijn H, Steen JVD, Steinman RM. Human eye movements associated with blinks and prolonged eyelid closure . J Neurophysiol . 1985;54:11-27. 14. Evinger C, Manning KA, Sibony PA. Eyelid movements: mechanisms and normal data . Invest Ophthalmol Vis Sci . 1991;32:387-400. 15. House JW, Brackmann DE. Facial nerve grading system . Otolaryngol Head Neck Surg . 1985;93:146-147. 16. Bahill AT, Clark ME, Stark L. The main sequence: a tool for studying human eye movements . Mathematical Biosci . 1975;24:191-204.Crossref 17. Bjork A. Electromyographic studies on the coordination of antagonistic muscles in cases of abcucens and facial palsy . Br J Ophthalmol . 1954;38:605-615.Crossref 18. Gowers WR. The movements of the eyelids . R Med Chirurg Soc Lond . 1879;62:429-440. 19. Bender MB. The nerve supply to the orbicularis muscle and the physiology of movements of the upper lid with particular reference to the pseudo Graefe phenomena . Arch Ophthalmol . 1936;15:21-30.Crossref 20. Manning KA, Evinger CE, Sibony PA. Eyelid movements before and after botulinum therapy in patients with lid spasms . Ann Neurol . 1990;28:653-660.Crossref 21. Netens A, Smet H. Lid lag in Guillain-Barré-Strohl syndrome . Arch Neurol . 1988;45:1046-1047.Crossref 22. Keane J. Lid lag in Guillain-Barré syndrome . Arch Neurol . 1975;32:478-479.Crossref 23. Anderson RL, Dixon RS. The role of Whitnall's ligament in ptosis surgery . Arch Ophthalmol . 1979;97:705-707.Crossref 24. Anderson RL, Beard C. The levator aponeurosis: attachments and their clinical significance . Arch Ophthalmol . 1977;95:1437-1441.Crossref 25. Hawes MJ, Dortzback RK. The microscopic anatomy of the lower eyelid retractors . Arch Ophthalmol . 1982;100:1313-1318.Crossref 26. Jones LT. The anatomy of the lower eyelid and its relation to the cause and cure of ectropion . Am J Ophthalmol . 1960;49:29-36. 27. Koorneef L. Spatial Aspects of Orbital Musculofibrous Tissue in Man . Amsterdam, the Netherlands: Swets & Zeitimeiger BV; 1977. 28. Sevel D. Ptosis and underaction of the superior rectus muscle . Ophthalmology . 1984;91:1080-1085.Crossref 29. Sevel D. A reappraisal of the origin of human extraocular muscles . Ophthalmology . 1981;88:1330-1338.Crossref 30. Evinger C, Manning KA. A model for motor learning: adaptive gain control of the blink reflex . Exp Brain Res . 1988;70:527-538.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1991

References

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