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From the Departments of Ophthalmology (Drs. Huffman, Baker, Chuke, Porter and Mr. Stava and Rouholiman), Neurology (Dr. Baker), and Anatomy and Neurobiology (Dr. Porter), University of Kentucky Medical Center, Lexington, KY.
Supported by a grant from the Benign Essential Blepharospasm Research Foundation (R.S.B. and J.D.P.), United States Public Health Service grant EY10760 from the National Eye Institute (R.S.B. and J.D.P.), and an unrestricted grant from Research to Prevent Blindness, Inc. (R.S.B.). B.R.R. was supported by a Howard Hughes Medical Institute Undergraduate Research FellowshipP. was a recipient of the Lew R. Wasserman Merit Award from Research to Prevent Blindness.
Received June 22, 1995. Accepted in final form August 14, 1995.
Address correspondence and reprint requests to Dr. R.S. Baker, Department of Ophthalmology, E304 Kentucky Clinic, University of Kentucky Medical Center, Lexington, KY 40536-0284.
We assessed eyelid function by subjective clinical examination and quantitative means in patients recovering from facial nerve palsy.Electromagnetic search coil techniques were used to record the concurrent movements of the two eyelids to study alterations in blink main sequence (peak velocity versus amplitude) relationships and interocular differences in eyelid kinematics. After onset of unilateral palsy, the paresis of eyelid closure showed varying degrees of recovery. Adaptive increases in blink main sequence slope contributed to maximizing closure of the paretic eyelid. However, blink adaptation mechanisms must operate bilaterally, as there also was evidence of altered main sequence slope in the nonparetic eyelid. In general, main sequence slope was inversely related to the level of eyelid paresis. The highest indices of blink adaptation were in those patients with moderate paresis, and main sequence slope was decreased in those patients with increasing degrees of recovery. The assessment of eyelid function with search coil techniques provides a sensitive means of monitoring disease and treatment course. Data also aid understanding of adaptive gain control in the neural control of blink in health and disease.
NEUROLOGY 1996;46: 1079-1085
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