Bell's Palsy-associated blepharospasm relieved by aiding eyelid closure

Ann Neurol. 1996 Feb;39(2):263-8. doi: 10.1002/ana.410390217.


The efficacy of the blink reflex is maintained by adaptive control mechanisms. We describe a 39-year-old woman with the rare complication of blepharospasm-like symptoms appearing contralateral to an eyelid weakened by facial nerve palsy. The hyperexcitable blink reflex may be a maladaptive consequence of adaptive systems but was not accompanied by an expected increase in main sequence slope. Eyelid spasms were eliminated by the implantation of a gold weight to assist closure of the paretic eyelid. We suggest that aiding closure of the weak eyelid in this case caused a reduction in blink system excitability via the same compensatory mechanisms that initially produced the eyelid spasm. Data also suggest that blink-adaptive systems act via changes in reflex excitability and/or main sequence relationships, and that these may be regulated either synergistically or independent of one another.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blepharospasm / etiology*
  • Blepharospasm / surgery*
  • Eyelids / physiopathology*
  • Facial Paralysis / complications*
  • Facial Paralysis / physiopathology*
  • Female
  • Gold
  • Humans
  • Prostheses and Implants*


  • Gold