[Unilateral apraxia of eyelid closure in ischemic stroke: role of the right hemisphere in the emotional gesture communication]

(Apraxia unilateral del cierre palpebral tras un ictus isquémico: el papel del hemisferio derecho en la comunicacion gestual mocional.)

Full Abstract

INTRODUCTION:
Apraxia of eyelid closure (AEC) is an infrequent disorder that is characterised by the inability to close the eyelids on command, although spontaneous blinking and reflex shutting of the eyes is preserved. Very few cases of unilateral AEC have been reported and no long-term follow-ups have been carried out. We report the case of a patient with unilateral AEC that was followed up over a 3-year period and also discuss the role played by the right hemisphere in this disorder. CASE REPORT" We examined the case of a 67-year-old right-handed male who was admitted because of a parietotemporal infarction with extension into the subcortex. A few days after the stroke the patient reported the inability to close his left eye on command, although he was still able to blink spontaneously and the blink and visual threat reflexes were preserved. This deficiency was associated to a dense hemiparesis on the left side and notable aprosodia affecting language. At 3 years' follow-up the AEC had not improved significantly.

CONCLUSIONS:
There are data to suggest that the right hemisphere is related to emotional perception and expressiveness, as well as the regulation of language prosody. Likewise, symbolic anthropology stresses the importance of winking as a gesture involved in non-verbal communication. These data suggest that AEC may be a consequence of a dysfunction of the role played by the right hemisphere in emotional expressiveness through gestures. The association with language aprosodia could support this hypothesis.

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Author information

Author/s: Pérez-Martínez, D A (DA); Puente-Muñoz, A I (AI); Doménech, J (J); Baztán, J J (JJ); Berbel-Garcia, A (A); Porta-Etessam, J (J);

Affiliation: Unidad de Neurología y Neurofisiología, Hospital Central de la Cruz Roja, Madrid, España. daperezm(-atsign-)yahoo.com

Journal and publication information

Publication Type: Case Reports; English Abstract; Journal Article

Journal: Revista de neurologia (Rev Neurol), published in Spain. (Language: spa)

Reference: -2007 Apr 1-15; vol 44 (issue 7) : pp 411-4

Dates: Created 2007/04/10; Completed 2007/10/02; Revised 2007/11/15;

PMID: 17420967, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Apraxias - etiology
Brain - pathology; physiology
Communication
Emotions

Eyelids
Gestures
Humans
Male
Stroke - complications; physiopathology

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