Eyelid Lag Without Eyelid Retraction in Pretectal Disease

• Published in: Journal of neuro-ophthalmology Vol. 16; no. 2; pp. 96 - 98
• Main Authors: Galetta, Steven L., Raps, Eric C., Liu, Grant T., Saito, Naoyuki G., Kline, Lanning B.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD by North American Neuro-Ophthalmology Society 01-06-1996; Lippincott Williams & Wilkins
• Subjects: Adult; Biological and medical sciences; Brain Diseases - complications; Brain Diseases - diagnosis; Eye Movements; Eyelid Diseases - etiology; Eyelids - innervation; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Mesencephalon - pathology; Motor Neuron Disease - complications; Motor Neuron Disease - diagnosis; Oculomotor disorders; Ophthalmology; Red Nucleus - pathology; Human; Nervous system diseases; Pathogenesis; Oculopalpebral asynergy; Midbrain; Cerebral disorder; Case study; Eye disease; Eyelid disease; Etiology; Central nervous system disease; Young adult; Lesion; Oculomotor syndrome
• ISSN: 1070-8022; 1536-5166
• DOI: 10.1097/00041327-199606000-00003

We report a patient with pretectal eyelid lag without retraction. MRI showed high signal abnormality dorsal to the right red nucleus in a region thought responsible for premotor eyelid control. The dissociation of eyelid lag from eyelid retraction in this patient would suggest that these lid signs may have separate neural mechanisms or pathways. We propose that the lesion interrupts inhibitory connections between the vertical gaze center and the central caudal nucleus.