Ghika J, Regli F, Assal G, Bogousslavsky J
Service de Neurologie, CHUV, Lausanne, Suisse.
Schweiz Arch Neurol Psychiatr (1985). 1988;139(6):5-21.
We studied 2 cases of supranuclear palsy of eye closure in patients who were unable to close their lids under command, but still conserved the possibility of closing them by syncinetic or reflex stimulations as well as during the sleep. The first patient had bilateral infarcts in sylvian watershed zones of fronto-parietal lobe and the second patient had a right cortico-subcortical superficial sylvian infarct. None of the 2 cases had an evolution towards motor impersistence of lid closure. We made a review of the literature and exposed the most debated hypothesis about this phenomenon, i.e. apraxia of lid closure or liberation of "grasping" phenomenon on the face. We expose the possibility of a disconnexion syndrome between motor supplementary area of the right hemisphere, supposed to be dominant for lid closure, and the premotor cortex area, based on reconstructions from CT Scan.
我们研究了2例核上性眼睑闭合麻痹患者，他们无法自主闭眼，但仍可通过联合运动或反射刺激以及在睡眠期间闭眼。首例患者额顶叶外侧裂分水岭区双侧梗死，第二例患者右侧皮质下皮质浅表外侧裂梗死。这2例患者均未发展为眼睑闭合运动不能持续。我们回顾了文献，并阐述了关于这一现象最具争议的假说，即眼睑闭合失用症或面部“抓握”现象的释放。基于CT扫描重建，我们提出了一种可能性，即推测对眼睑闭合起主导作用的右半球运动辅助区与运动前皮质区之间存在失连接综合征。
