Apraxia of Eyelid Opening

Summary • Symptoms of apraxia of eyelid opening and benign essential blepharospasm (BEB) both present with difficulty opening eyes. However, there are key differences o Blepharospasm: spasm of orbicularis oculi, squeezing, eye lashes are buried o Apraxia of eyelid opening: eyes are passively closed like you are going to sleep -Can use sensory tricks to manually open their eyes (e.g., patient may rub forehead or tap themselves on the cheek) • Treatment of apraxia of eyelid opening and BEB o Botulinum toxin into the pretarsal orbicularis oculi to relieve inhibition of the levator palpebrae superioris • As these are a form of focal palpebral dystonia, both conditions can occur in other dystonias (e.g., Parkinson's Disease, progressive supranuclear palsy