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Apraxia of Lid Opening

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Encyclopedia of Ophthalmology

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Definition

Apraxia of lid opening (ALO) is a potentially disabling syndrome characterized by a non-paralytic difficulty in voluntary initiation of the act of lid elevation after lid closure. Although called an apraxia, apraxia of lid opening is not a true apraxia (typically defined as a voluntary inability to perform a motor task to command). ALO may present with difficulty to open the eyes in one instance but then be normal in other instances. The pathophysiology of ALO is poorly understood, but the predominant proposed theory is thought to be related to an abnormality in the supranuclear control of voluntary elevation of the eyelid. The normal eyelid opening requires an activation of the levator palpebrae superioris muscle (LPS) and the concomitant inhibition of orbicularis oculi muscle (OO). Electromyographic (EMG) studies have revealed involuntary LPS inhibition and persistent contraction of pretarsal OO in some patients. Anatomically the LPS receives bilateral innervation from the...

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Further Reading

  • Aramideh M, Bour LJ, Koelman JH, Speelman JD, Ongerboer de Visser BW (1994) Abnormal eye movements in blepharospasm and involuntary levator palpebrae inhibition. Clinical and pathophysiological considerations. Brain 117(Pt 6):1457–1474

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  • Boghen D (1997) Apraxia of lid opening: a review. Neurology 48:1491–1494

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  • Jordan DR, Anderson RL, Digre KB (1990) Apraxia of lid opening in blepharospasm. Ophthalmic Surg 21(5):331–334

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  • Krack P, Marion MH (1994) “Apraxia of lid opening,” a focal eyelid dystonia: clinical study of 32 patients. Mov Disord 9(6):610–615

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  • Lepore FE, Duvoisin RC (1985) “Apraxia” of eyelid opening: an involuntary levator inhibition. Neurology 35:423–427

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Authors and Affiliations

  1. Department of Neurology, University of Texas Health Science Center, San Antonio, TX, USA

    Nagham Al-Zubidi

  2. Blanton Eye Institute, Houston Methodist Hospital, 6560 Fannin Street, Scurlock 450, Houston, TX, 77030, USA

    Andrew G. Lee

  3. Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, TX, USA

    Andrew G. Lee

  4. Department of Ophthalmology, The University of Texas Medical Branch, Galveston, TX, USA

    Andrew G. Lee

  5. UT MD Anderson Cancer Center, Houston, TX, USA

    Andrew G. Lee

  6. Baylor College of Medicine, Houston, TX, USA

    Andrew G. Lee

  7. Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Andrew G. Lee

  8. Eye Wellness Center/ Neuro-Ophthalmology of Texas, PLLC, Houston, TX, USA

    Nagham Al-Zubidi

  9. Assistant Professor of Ophthalmology, Institute for Academic Medicine Assistant Clinical Member, Research Institute Department of Ophthalmology-Blanton Eye Institute, Houston Methodist Hospital Houston Methodist, Houston, TX, USA

    Nagham Al-Zubidi

  10. Clinical Assistant Professor of Ophthalmology Weill Cornell Medical College, NewYork, NY, USA

    Nagham Al-Zubidi

Authors
  1. Nagham Al-Zubidi
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  2. Andrew G. Lee
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Corresponding author

Correspondence to Andrew G. Lee .

Editor information

Editors and Affiliations

  1. Dept of Ophthal & Optometry,AKH, Medical University of Wien Dept of Ophthal & Optometry,AKH, Wien, Austria

    Ursula Schmidt-Erfurth

  2. Department of Ophthalmology, Goethe University of Frankfurt am Main Department of Ophthalmology, Frankfurt am Main, Germany

    Thomas Kohnen

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© 2015 Springer-Verlag Berlin Heidelberg

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Al-Zubidi, N., Lee, A.G. (2015). Apraxia of Lid Opening. In: Schmidt-Erfurth, U., Kohnen, T. (eds) Encyclopedia of Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35951-4_969-1

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  • DOI: https://doi.org/10.1007/978-3-642-35951-4_969-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-35951-4

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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