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Last Month’s Blink

Marin-Amat Syndrome

Written by Sumana S. Kommana, MD, and Upneet K. Bains, MD, Temple University Hospital, Philadelphia. Photo By Sumana S. Kommana, MD.

A 20-year-old man com­plained of involuntary clo­sure of his right eye when he smiled. He had been diagnosed with and treated for right-side Bell palsy about a year ago, with nearly complete resolution of his symp­toms. Examination revealed closure of both the upper and lower right eyelids upon smiling. The ocular exam was otherwise normal, and his visual acuity was 20/20 in both eyes.

Synkinesis is described as in­voluntary muscle movements that are triggered by voluntary muscle movements. Marin-Amat syndrome specifically refers to a rare form of facial synkinesis in which the orbicularis oculi muscle is activated with the voluntary movement of the lower facial muscles (e.g., smiling).¹ It is thought to be caused by aberrant seventh nerve regener­ation after trauma or as a result of Bell palsy. In this patient, the decision was made to monitor the symptoms closely and to consider botulinum toxin injections in the future.

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1 Jethani J. Indian J Ophthalmol. 2007;55(5):402-403.

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