Bell's palsy-induced blepharospasm relieved by passive eyelid closure and responsive to apomorphine.
OBJECTIVE
We describe the case of a woman with Bell's Palsy-induced blepharospasm (BPIB) of the right eye that appeared simultaneously with a complete left facial nerve palsy. The involuntary spasm was relieved by passive lowering of the upper eyelid on the paretic side.


METHODS
The recovery curve of the blink reflex was evaluated on the non-paretic side in baseline conditions, after subcutaneous apomorphine and placebo administration and 8 months later, at recovery from the palsy.


RESULTS
We found increased recovery of the test-R2 responses at short interstimulus intervals at baseline, which was normalised by apomorphine but not by placebo. At recovery the blink reflex R2 recovery curve returned to normal.


CONCLUSIONS
This report demonstrates for the first time a response of BPIB to a dopamine agonist.


CONCLUSIONS
Our findings are in agreement with an animal model of blepharospasm that suggests a combined role of weakness of the orbicularis oculi muscle and a dysfunction of the dopaminergic system in the pathogenesis of this disorder.
Cattaneo
Luigi
L
Dipartimento di Neuroscienze, Sezione di Neurologia, Università degli Studi di Parma, Via Gramsci 14, 43100 Parma, Italy. luigi.cattaneo@nemo.unipr.it
Chierici
Elisabetta
E
Pavesi
Giovanni
G
D001058:Apomorphine / Q000627:therapeutic use*; D020330:Bell Palsy / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D001764:Blepharospasm / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D001767:Blinking / Q000502:physiology*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004568:Electrodiagnosis; D004576:Electromyography; D005143:Eyelids / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D009460:Neurologic Examination
D018491:Dopamine Agonists; D001058:Apomorphine