I examined a patient who showed retraction of the right eyelid on vomiting. The right eyelid of the patient elevated concomitantly with the induction of gag reflex. She did not have ptosis. The levator function of the both eyes was normal. This case would be the first case report of glossopharyngeal-vagal-oculomoter synkinesis in the literature.
Eyelids* ; Humans ; Reflex ; Synkinesis ; Vomiting*

Eyelid retraction occurs secondary to various disease entities. To our knowledge, there has not been any report on the etiology of eyelid retraction in Korea. The authors have observed 47 patients with unilateral or bilateral eyelid retraction and studied the etiologies. Eyelid retractions were commonly associated with thyroid ophthalmopathy, traurna and neuropathic causes in adults, and paradoxic synkinesis of levator palpebrae muscle and thyroid ophthalmopathy in children. Unilateral eyelid retractions were most commonly associated with neuropathic causes, and thyroid ophthalmopathy is the most common cause in bilateral eyelid retractions. In contrary to the previous reports, lower lid retraction was characteristically more common than upper lid retraction in thyroid.
Adult ; Child ; Eyelids* ; Humans ; Korea ; Synkinesis ; Thyroid Gland

OBJECTIVE: The goal of this study was to examine association between tardive dyskinesia and soft neurological signs in schizophrenic patients. METHODS: 35 schizophrenic inpatients who met the diagnostic criteria for tardive dyskinesia developed by Schooler and Kane and 30 schizophrenic inpatients without tardive dyskinesia were enrolled in this study. Tardive dyskinesia, soft neurological signs, and cognitive function were evaluated with Abnormal Involuntary Movement Scale (AIMS), Neurological Evaluation Scale (NES), and Mini-Mental State Examination (MMSE) independently by 2 psychiatrists, respectively. Data of the two schizophrenic groups were compared and also those of 31 normal controls. RESULTS: Total schizophrenics scored higher than normal controls in total mean scores of NES (p<0.01), and its three functional area scores, sensory integration (p<0.01), motor coordination (p<0.05), and sequencing of complex motor acts (p<0.05). Patients with tardive dyskinesia showed higher prevalence rates than those without in 5 items-left graphesthesia (p<0.05), right fist-ring test (p<0.05), right fist-edge-palm test (p<0.05), right synkinesis (p<0.05), and left synkinesis (p<0.05). The total scores of NES were not significantly related to the severity of tardive dyskinesia and cognitive dysfunction. CONCLUSION: Schizophrenics had more soft neurological signs than normal subjects. Five items of NES were more impaired in the patients with tardive dyskinesia than in those without tardive dyskinesia.
Dyskinesias ; Humans ; Inpatients ; Movement Disorders* ; Prevalence ; Psychiatry ; Schizophrenia ; Synkinesis

Simultaneous contraction of various muscles with levator palpebrae have been reported as a phenomenon of the paradoxic synkinesis. The authors observed an unilateral eyelid retraction induced by the postural change from supine to sitting position in a 33-month-old girl and a 4-year-old boy. In both cases, the levator function of both eyes was normal and ptosis was not observed. These cases were presumed to be related with postural righting reflex, but the exact neurological basis is not fully defined yet.
Child, Preschool ; Eyelids* ; Female ; Humans ; Male ; Muscles ; Reflex, Righting ; Synkinesis

synkinesis still plague even the best reconstructions. The reconstructive techniques used still represent a compromise between obtainable symmetry and motion at the expense of donor site deficits, but current techniques continue to refine and limit this morbidity. In chronically paralyzed face, direct nerve anastomosis, nerve graft, or microvascular-muscle graft is not always possible. In this case, regional muscle transposition is tried to reanimate the eyelid and lower face. Regional muscle includes maseeter muscle, temporalis muscle and anterior belly of the digastric muscle. Temporalis muscle is preferred because it is long, flat, pliable and wide-motion of excursion. In order to reanimate the upper and lower eyelid, Upper eyelid Gold weight implantion and lower eyelid shortening and tightening is mainly used recently, because this method is very simple, easy and reliable.]]>
Eyelids ; Humans ; Plague ; Rehabilitation ; Synkinesis ; Tissue Donors ; Transplants

PURPOSE: This case is the first report of unilateral ptosis associated with paradoxical movement on abduction in Korean literature and we report this case with a successful result of operations. METHODS: We examined an 18-year-old male patient who had showed drooping of right eyelid since birth. The ptosis was exaggerated on abduction. He did not have any remarkable history of illness. Corrected visual acuity was 20/20 in both eyes. Ocular motility examination revealed full range of ductions and versions in all fields of gaze. On exophthalmometric examination, no difference was found in any direction of gaze between two eyes. Under the diagnosis of unilateral ptosis associated with paradoxical movement on abduction, levator resection of right upper lid and blepharoplasty of left upper lid were performed. RESULTS: During operation, we noticed unusual finding that thickened tendon sheath was covering the lateral one third of levator aponeurosis. Paradoxical eyelid movement disappeared completely after secondary operation by removal of the previously noticed tendon sheath as much as possible.
Adolescent ; Blepharoplasty ; Blepharoptosis* ; Diagnosis ; Eyelids ; Humans ; Male ; Parturition ; Synkinesis ; Tendons ; Visual Acuity

BACKGROUND AND PURPOSE: Hemifacial spasm is clinically characterized by involuntary co-contraction of unilateral facial muscles innervated by facial nerve and presence of synkinetic response between facial muscles innervated by different branches of facial nerve is considered as the electrophysiological hallmark of this disease. We performed this study in order to analyse and thereby to approach the pathogenesis of these synkinetic responses in detail. METHODS: Blink reflex test was applied to the 21 patients with hemifacial spasm. With some modification of conventional blink reflex methodology, synkinetic responses between orbicularis oculi and orbicularis oris muscles were recorded on both affected and unaffected sides. RESULTS: Among 21 patients, 10( 47.6% ) showed synkinetic responses both on affected and unaffected side, 8( 38.1% ) only on affected side, and 3( 14.3% ) did not show any evidence of synkinesis on either side. CONCLUSION: These findings could be considered as additional supportive evidence that the facial neuronal hyperexcitability is working in hemifacial spasm as synkinesis on unaffected side cannot be explained solely by peripheral mechanism. Further research on change of synkinetic behavior after microvascular decompression surgery seems to be needed.
Blinking* ; Facial Muscles ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery ; Muscles ; Neurons ; Synkinesis

Various patterns of synkinesis with levator palpebrae have been reported as a phenomenon of the aberrant innervation.Synkinetic levator innervation of extraocular muscles has been reported infrequently.Primary oculomotor synkinesis on attempting to gaze downward and adduction has been once reported to date on a congenital and inherited basis. This report concerns unilateral eyelid retraction induced by depression and adducting eye movement in a 4-year-old girl without any previous oculomotor palsy.
Child, Preschool ; Depression* ; Eye Movements ; Eyelids* ; Female ; Humans ; Muscles ; Paralysis ; Synkinesis

We examined a 4-year-old girl who had showed retraction of the left upper eyelid on downward gaze since birth. She had no history of birth trauma, eye surgery, or oculomotor nerve palsy. Corrected visual acuity was 0.3 OU. Motility examination revealed no phoria or tropias. Full ductions and versions were present in all fields of gaze. In primary gaze, the upper eyelids were in normal position and symmetric, and the levator function of the both eyes was normal. On downward gaze, the left upper eyelid was retracted 3.5 mmcompared with the right upper lid. On left and downward gaze, the left upper lid retraction increased to 8 mm. Result of computed tomography of brain and orbits was normal. This case is clinically rare and may be the first report of congenital levator-inferior rectus synkinesis in the Korean literature.
Brain ; Child, Preschool ; Eyelids ; Female ; Humans ; Oculomotor Nerve Diseases ; Orbit ; Parturition ; Strabismus ; Synkinesis* ; Visual Acuity

Botulinum toxin type A(BTA) is well known treatment agent in the treatment of paralytic strabismus in ophthalmological field for more than 15 years. Its therapeutic potential as temporary paralyzing agent was adopted to treat several neurologic, movement disorders. In recent years, BTA is considered as initial medical treatment option in such as blepharospasm, hemifacial spasm, spasmodic torticollis, spasmodic dysphonia. Authors applied BTA injection in cases with spasmosmodic torticollis, hemifacial spasm, facial synkinesis and experienced staisfactory result. So authors present our experience of BTA injection therapy and discuss techniques, advantages and disavantages.
Blepharospasm ; Botulinum Toxins* ; Botulinum Toxins, Type A ; Dysphonia ; Dystonia ; Hemifacial Spasm* ; Movement Disorders ; Strabismus ; Synkinesis* ; Torticollis*