Periodic unilateral eyelid retraction in a pediatric patient

Nandini G Gandhi; Gina M Rogers; Randy H Kardon; Richard C Allen

doi:10.1097/WNO.0b013e31822db30b

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Periodic unilateral eyelid retraction in a pediatric patient

Journal article

Peer reviewed

Periodic unilateral eyelid retraction in a pediatric patient

Nandini G Gandhi, Gina M Rogers, Randy H Kardon and Richard C Allen

Journal of neuro-ophthalmology, Vol.31(4), pp.350-352

12/2011

DOI: 10.1097/WNO.0b013e31822db30b

PMID: 21878821

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Abstract

A healthy 11-year-old girl presented with right upper eyelid retraction since birth. An evaluation including thyroid function studies and neuroimaging was negative, and the patient was scheduled for a right levator recession to address the eyelid malposition. Intraoperatively, after the induction of inhalational general anesthesia, the patient displayed cyclic right upper eyelid retraction. Occurring in intervals of exactly 48 seconds, these cycles involved a rapid elevation of the right eyelid from a position of half-closure to a retracted position just above the superior limbus. There was no change in pupil size or eye position during these cyclic spasms, and the contralateral eyelid was unaffected. The patient underwent an uncomplicated levator recession, which improved the upper eyelid retraction. Postoperative testing, including external motility video and infrared pupillometry, demonstrated no cyclic variation in eyelid position, eye position, or pupil size in the waking state. This is a unique case of unilateral eyelid retraction with periodic spasms under conditions of anesthesia without a preexisting oculomotor paresis; it represents an unusual variation on congenital eyelid retraction and classically described cyclic oculomotor palsy.

Anesthesia, General

Diagnosis, Differential

Spasm - surgery

Humans

Periodicity

Eyelid Diseases - etiology

Eyelid Diseases - diagnosis

Oculomotor Muscles - surgery

Video Recording

Female

Spasm - etiology

Eyelid Diseases - surgery

Child

Spasm - diagnosis

Details

Title: Subtitle: Periodic unilateral eyelid retraction in a pediatric patient
Creators: Nandini G Gandhi - Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA. nandini.gandhi@gmail.com
Gina M Rogers
Randy H Kardon
Richard C Allen
Resource Type: Journal article
Publication Details: Journal of neuro-ophthalmology, Vol.31(4), pp.350-352
DOI: 10.1097/WNO.0b013e31822db30b
PMID: 21878821
NLM abbreviation: J Neuroophthalmol
ISSN: 1070-8022
eISSN: 1536-5166
Publisher: United States
Language: English
Date published: 12/2011
Academic Unit: Iowa Neuroscience Institute; Ophthalmology and Visual Sciences
Record Identifier: 9983980088502771

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