title: Bell's Palsy-associated blepharospasm relieved by aiding eyelid closure.
abstract: The efficacy of the blink reflex is maintained by adaptive control mechanisms. We describe a 39-year-old woman with the rare complication of blepharospasm-like symptoms appearing contralateral to an eyelid weakened by facial nerve palsy. The hyperexcitable blink reflex may be a maladaptive consequence of adaptive systems but was not accompanied by an expected increase in main sequence slope. Eyelid spasms were eliminated by the implantation of a gold weight to assist closure of the paretic eyelid. We suggest that aiding closure of the weak eyelid in this case caused a reduction in blink system excitability via the same compensatory mechanisms that initially produced the eyelid spasm. Data also suggest that blink-adaptive systems act via changes in reflex excitability and/or main sequence relationships, and that these may be regulated either synergistically or independent of one another.
authors.affiliation: Department of Ophthalmology, University of Kentucky Medical Center, Lexington, KY 40536-0284, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Chuke
authors.forename: R S
authors.initials: RS
authors.lastname: Baker
authors.forename: J D
authors.initials: JD
authors.lastname: Porter
mesh_terms: D000328:Adult; D001764:Blepharospasm / Q000209:etiology* / Q000601:surgery*; D005143:Eyelids / Q000503:physiopathology*; D005158:Facial Paralysis / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006046:Gold; D006801:Humans; D019736:Prostheses and Implants
chemical_list: D006046:Gold