Thixotropy of levator palpebrae as the cause of lagophthalmos after peripheral facial nerve palsy.
نویسندگان
چکیده
Patients with facial nerve palsy are at risk of developing corneal ulceration because of lagophthalmos (incomplete closure of the affected eyelid). Lagophthalmos could result from thixotropy of the levator palpebrae muscle--that is, the formation of tight crossbridges between the actin and myosin filaments of the muscle fibres causing stiffness of the muscle--rather than from paralysis of the orbicularis occuli muscle as previously supposed. This possibility was investigated in 13 patients with a peripheral facial nerve palsy in a prospective open study. The levator muscle of the affected eyelid was stretched by manipulation and downward movement of the passively closed upper eyelid for approximately 15 seconds. The amount of lagophthalmos was measured before and immediately after this manoeuvre. In all patients except one there was a clear reduction in lagophthalmos (mean reduction 72%; range 60-100%). Thus in this setting the lagophthalmos appears to be caused by thixotropy of the levator palpebrae muscle, which has implications for treatment.
منابع مشابه
Valeria Sansone , James Boynton and Cynthia Palenski disease
All since 1951, it is now a weekly with 48 issues per year. Article abstract-Upper eyelid gold-weight implants are widely used in the correction of lagophthalmos in many neuromuscular conditions, most commonly facial palsy. The paralytic lagophthalmos that occurs in facioscapulohumeral muscular dystrophy (FSHD) is common and can cause severe ocular complications. It is not usually considered fo...
متن کاملA technique for lid loading in the management of the lagophthalmos of facial palsy.
Weighting of the upper lid with gold, to provide closure and cosmetic improvement in a lagophthalmos due to facial palsy, has found increasing acceptance among plastic surgeons and ophthalmologists since it was described by Smellie9 in 1966. The technique we have developed after a 4-year experience with this procedure has proved to be good, and it can be easily modified as the clinical circumst...
متن کاملRamsay Hunt Syndrome Associated with True Vocal Cord Palsy- A Case Report
Introduction: Varicella-zoster virus may cause an infectious disease called Ramsay Hunt syndrome. The related symptoms include facial nerve palsy (FNP), otalgia, the vesicular eruptions of the auricle and external auditory canal, less common ocular movement disorder, facial hypoesthesia, myofascial pain, vestibular symptoms, hearing loss, dysphasia, vocal cord paralysis, as well as tongue paral...
متن کاملPtosis as the only manifestation of diabetic superior division oculomotor nerve palsy
RATIONALE Diabetic oculomotor nerve palsies, also called ischemic third nerve palsies, are the most common etiologic subset of oculomotor nerve palsy in adults. Diabetic oculomotor nerve palsies typically present with ptosis and diplopia, but pupillary function is often spared. The oculomotor nerve separates into superior division and inferior division, with the superior division innervating th...
متن کاملRestoration of movement to the upper eyelid in facial palsy by an individual gold implant prosthesis.
F acial nerve palsy causes lagophtalmia of the upper lid (Fig. 1). In addition to being an esthetic deformity, it may lead to recurrent keratitis, keukoma, conjunctivitis, and even blindness. In facial palsy, overaction of the levator palpebrae muscle is present. Closure of the eye and downward movement of the lid can be achieved by adding weight to the upper lid. This article describes a techn...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of neurology, neurosurgery, and psychiatry
دوره 72 5 شماره
صفحات -
تاریخ انتشار 2002