Can You Guess December's Mystery Condition?
Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
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.
1 Jethani J. Indian J Ophthalmol. 2007;55(5):402-403.
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