Teaching Video NeuroImages: Apraxia of eyelid closure following right hemispheric infarction

A 56-year-old man presented following a right middle cerebral artery territory infarction (figure). In addition to left hemiparesis and neglect, he was unable to close his left eye on command (video at Neurology.org), though he was able to blink spontaneously and keep his eyes closed during sleep. He could maintain closure of both eyes once manually closed. Apraxia of eyelid closure is distinguished clinically from eyelid closure weakness by ability to blink reflexively and maintain eyelid closure. Activation of the oculomotor cortex has been associated with voluntary eyelid closure and lesions in right frontal and parietal lobes with eyelid closure apraxia.1,2
Source: Neurology - Category: Neurology Authors: Tags: Clinical neurology examination, All Neuro-ophthalmology, Eyelids, Infarction RESIDENT AND FELLOW SECTION Source Type: research