[Inability to voluntarily close the eyes. Discussion of supranuclear disorders in palpebral closure based on 2 cases, with a review of the literature].
We studied 2 cases of supranuclear palsy of eye closure in patients who were unable to close their lids under command, but still conserved the possibility of closing them by syncinetic or reflex stimulations as well as during the sleep. The first patient had bilateral infarcts in sylvian watershed zones of fronto-parietal lobe and the second patient had a right cortico-subcortical superficial sylvian infarct. None of the 2 cases had an evolution towards motor impersistence of lid closure. We made a review of the literature and exposed the most debated hypothesis about this phenomenon, i.e. apraxia of lid closure or liberation of "grasping" phenomenon on the face. We expose the possibility of a disconnexion syndrome between motor supplementary area of the right hemisphere, supposed to be dominant for lid closure, and the premotor cortex area, based on reconstructions from CT Scan.
Ghika
J
J
Service de Neurologie, CHUV, Lausanne, Suisse.
Regli
F
F
Assal
G
G
Bogousslavsky
J
J
D000368:Aged; D001764:Blepharospasm / Q000503:physiopathology*; D001767:Blinking; D002341:Carotid Artery Thrombosis / Q000503:physiopathology; D002544:Cerebral Infarction / Q000503:physiopathology*; D004292:Dominance, Cerebral / Q000502:physiology; D005141:Eyelid Diseases / Q000503:physiopathology*; D005143:Eyelids / Q000294:innervation; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010296:Parietal Lobe / Q000503:physiopathology; D013494:Supranuclear Palsy, Progressive / Q000503:physiopathology*
Impossibilité à la fermeture volontaire des paupières. Discussion sur les troubles supranucléaires de la fermeture palpébrale à partir de 2 cas, avec revue de la littérature.