A patient with neuritic leprosy developed borderline skin lesions. Later, another skin lesion developed on the left side of the forehead with clinical involvement of the supraorbital branch of the ophthalmic division of the trigeminal nerve. Simultaneously, paralysis of the occipitofrontalis and mild paresis of orbicularis oculi occurred.

BACKGROUND This article describes a preperiosteal midcheek lift technique performed by means of the midcheek soft-tissue spaces by precise release of the retaining ligaments that separate the spaces. METHODS From November of 2009 to June of 2014, 184 patients underwent this procedure. A transcutaneous lower eyelid blepharoplasty incision was used to access the preseptal space. Medially, the o...

The corneal and blink reflexes were evaluated in 20 normal subjects and in 30 patients with motor deficits secondary to unilateral hemispheral lesions of vascular origin. In the normal population there were no differences between subjects below and subjects above 50 years of age. In the patients the reflex evoked by electrical stimulation of the cornea of the clinically affected side was depres...

Spontaneous and voluntary eyelid motility is often abnormal in patients with progressive supranuclear palsy. In contrast, their eyelid reflex responses are relatively preserved, and only those generated by an acoustic startle have been found absent or severely reduced. We hypothesized that, because of their relevant brainstem pathology, patients with progressive supranuclear palsy might have ot...

The anatomy of the midcheek has not been satisfactorily described to adequately explain midcheek aging and malar mounds, nor has it suggested a logical approach to their correction or provided sufficient detail for safe surgery in this area. This cadaver study, which was complemented by many operative dissections, located a missing link: a glide plane space overlying the body of the zygoma. The...

The Ochoa syndrome is the association of a non-neurogenic neurogenic bladder with abnormal facial muscle expression. Patients are at risk for renal failure due to obstructive uropathy. We report a family of three siblings, with an emphasis on the abnormalities in facial expression. Careful examination shows an unusual co-contraction of the orbicularis oculi and orbicularis oris muscles only whe...

Butler (I 948) described a simple operation for entropion; a triangular piece of tarsal plate and conjunctiva, base down and apex almost at the lid margin, was removed with blunttipped scissors "to avoid damage to the muscle fibers" (of orbicularis oculi). Kwitko (i 964) described a very similar procedure. The operation reported here has been in use at the Sussex Eye Hospital, Brighton, for som...

Blepharospasm, a focal dystonia characterized by involuntary orbicularis oculi muscle spasms, may vary in severity from a slightly bothersome condition to a disabling disorder that renders patients functionally blind. Botulinum toxin (BTX) injection, the gold-standard treatment, has a beneficial effect in 95% of patients. Oral medication is of limited efficacy. For individuals that do not respo...