Rth. Pham et al., CONGENITAL SYNKINETIC MOVEMENTS ASSOCIATED WITH ELEVATION OF THE UPPER EYELID, Ophthalmic plastic and reconstructive surgery, 10(1), 1994, pp. 30-33
Congenital synkinetic movement of the upper eyelid is rare. In this ca
se report, we present a 4-year-old patient with a left upper eyelid pt
osis that improved on abduction and became worse on adduction. The pat
ient also had congenital esotropia and superior rectus palsy. Strabism
us surgery was performed, and excellent surgical results were achieved
. A 17-mm left levator aponeurectomy and myectomy was later performed
with satisfactory results. Pathology studies of the levator muscle and
aponeurosis showed no evidence of inflammation, degeneration, or atro
phy. Electron microscopy showed no skeletal muscle abnormality. We pos
tulate that this congenital synkinetic movement reflects an incomplete
nerve cell dying process that occurs during the embryonic phase of de
velopment.