Ptosis

Retracción palpebral de causa neurológica: Presentación de tres pacientes, interpretación patogénica

“…Experimentalmente se ha demostrado que la apertura ocular se puede activar estimulando áreas de la corteza prefrontal 12 . Esta relación cór-tico-palpebral tiene su expresión fisiológica en la apertura de los ojos al despertar, que sugiere conexiones retículo-corticales permanentes.…”

“…La sobreelevación palpebral en la enfermedad de Creutzfeldt-Jakob, o "mirada hierática", suele asociarse a ceguera cortical, indudablemente originada en el compromiso de la corteza occipital, donde existen áreas reconocidas, cuyo estímulo experimental produce apertura ocular 12 . Esta sobreelevación palpebral en la ECJ tiene además un valor clínico-diagnóstico semejante al de las mioclonías 16 .…”

Ipsilateral Ptosis Associated with Anterior Thalamic Infarction

“…The higher frequency of ptosis following right compared to left hemisphere lesions has been explained by the hypothesis that the supranuclear center in the right precentral cortex is dominant over the supranuclear center in the left precentral cortex [8][9][10] . However, other studies found that cerebral ptosis can occur asymmetrically or unilaterally in ipsilateral or contralateral levator palpebrae and following left as well as right hemisphere injury [1,2] . Thus, as has been postulated, anatomic variants may exist such that 'the central caudal nucleus of the levators has separate neuronal pools segregated for the right and left eye lids' [2,10] or the premotor control of the levator palpebrae is at least in part lateralized.…”

“…At discharge (8 days after stroke), his motor weakness, facial palsy and dysarthria had disappeared, but the right ptosis and cognitive defi cits persisted. The ptosis still remained unchanged at 10 months after stroke.Any damage to the supranuclear motor circuits that supply the levator palpebrae can result in what has been termed 'cerebral ptosis' [1,2] . Cerebral ptosis is more frequent after right than left hemispheric strokes, and its frequency has been reported to be up to 37.5% [2] .…”

Smile-wink phenomenon: aggravated narrowing of palpebral fissure by smiling after lenticulocapsular stroke

“…Various eyelid abnormalities such as ptosis [4,7,16,19], blepharospasm [8,9,10,14,19] and apraxia of lid opening [3,13,15,19] have been shown to be caused by cerebral lesions without involving ocular or brainstem structures. However, unilateral narrowing of the palpebral fissure aggravated by smiling has not yet been described.…”