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A Relationship Between Blinking and Extraocular Muscle Fatigue?

Roger Kurlan, MD; Joseph Jankovic, MD; Allen Rubin, MD; Bernard Patten, MD; Robert Griggs, MD; Ira Shoulson, MD

Arch Neurol. 1987;44(10):1057-1060.

Abstract
• We studied five patients with a combination of Meige's syndrome (blepharospasm—oromandibular dystonia) and myasthenia gravis. The coexistence of two disorders impairing eyelid opening led to diagnostic confusion and delayed appropriate therapy. Detailed oculographic monitoring of one patient indicated that eye position drifting due to myasthenic oculomotor fatigue was corrected by eye blinks, and that blinks tended to occur with slower saccades. Our observations suggest that fatigue of extraocular muscles may lead to synkinetic blinking and perhaps eventually to autonomous blepharospasm.

Author Affiliations
From the Department of Neurology, University of Rochester School of Medicine, Rochester, NY (Drs Kurlan, Rubin, Griggs, and Shoulson), and the Department of Neurology, Baylor College of Medicine, Houston (Drs Jankovic and Patten).

Footnotes
Accepted for publication May 28, 1987.

Reprint requests to Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642 (Dr Kurlan).

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