Acta Neurologica Belgica

, Volume 112, Issue 1, pp 95–96 | Cite as

Combination of blepharospasm and apraxia of eyelid opening: a condition resistant to treatment

Case Report
First Online:
Received:
Accepted:

Abstract

Blepharospasm is seen in many cases of Parkinsonism including progressive supranuclear palsy. These patients usually respond well to botulinum toxin, however some patients subsequently fail to respond to even higher doses of botulinum toxin after an initial good response. They should not be considered failure of treatment with botulinum toxin, as a significant number of these patients have underlying apraxia of eyelid opening in addition to blepharospasm, which may be the cause of failure to respond to botulinum toxin. Combination of eyelid crutches or myomectomy with botulinum toxin is more effective in these patients as compared to an individual treatment modality. In this report, we present two patients with progressive supranuclear palsy who failed to respond to botulinum toxin because they had underlying apraxia of lid opening. Partial myomectomy in one patient and eyelid crutches in the other in combination with botulinum toxin lead to a much better response to botulinum toxin.

Keywords

Parkinson’s disease Blepharospasm and apraxia of eyelid opening Botulinum toxin and myectomy 
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Notes

Conflict of interest

None.

References

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Copyright information

© Belgian Neurological Society 2012

Authors and Affiliations

  1. 1.Parkinson’s Clinic of Eastern Toronto and Movement Disorders CentreTorontoCanada

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