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An Electromyographic Study of Unilate Oculopalpebral and Bilateral Mandibulopalpebral (Marcus Gunn) Synkineses in a 74-Year-Old Man

Robert S. Hepler, MD; William F. Hoyt, MD; John D. Loeffler, MD

Arch Neurol. 1968;18(4):416-424.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Most LOST electromyographic (EMG) studies of paradoxical synkineses between the eye or jaw movement and upper eyelid movement have concerned primarily the synkinetic excitation of levator neurons and the resulting lid retraction. A neglected, but equally important, physiologic aspect of these congenital anomalies of levator innervation is the mechanism underlying the ptosis which is usually associated with them. Commonly dismissed as partial paresis, this ptosis represents a congenital disorder of brain stem cells and inhibitory mechanisms affecting levator neurons.

This report presents clinical and electromyographic evidence of anomalous inhibition in a 74-year-old man whose right lid would fall during ipsilateral ocular adduction or elevation (synkinetic levator inhibition), and whose upper lids would retract, together or alternately, during various jaw movements (synkinetic levator excitation, the Marcus Gunn synkinesis).

Report of a Case

A 74-year-old white man examined at the University of California Medical Center (San Francisco) for mild symptoms of . . . [Full Text PDF of this Article]

Author Affiliations
San Francisco

From the Department of Neurology, University of California School of Medicine, San Francisco. Dr. Hepler is a Special Fellow in Neuro-ophthalmology with the support of National Institutes of Health grant NB-1501. His present address is the Jules Stein Institute, University of California at Los Angeles School of Medicine. Dr. Loeffler is presently in private practice in Modesto, Calif.

Footnotes
Submitted for publication Nov 3, 1967; accepted Nov 13.

Reprint requests to Department of Neurology, University of California School of Medicine, San Francisco, Calif 94122 (Dr. Hoyt).

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