Apraxia Of Eyelid Opening

Defazio et al. (1998) described 10 new patients with 'so-called apraxia of eyelid opening.' They concluded that the term 'apraxia' may not be the correct descriptive term even when the eyelid disturbance occurs without any other central nervous system disease. Familial clustering of the isolated finding in 1 patient was consistent with a genetic contribution: 2 brothers, their father, and 2 paternal aunts were thought to be affected. Combining their 10 patients with 11 previously reported cases of isolated so-called apraxia of eyelid opening, Defazio et al. (1998) found that the peak age at onset was the sixth decade and that there was a female preponderance of 2 to 1. The characteristic inability to initiate lid elevation was frequently associated with failure to sustain lid elevation, thus suggesting that eyelid motor control may be abnormal. The authors suggested that the extrapyramidal system is involved in the pathophysiology of isolated apraxia of eyelid opening.