Apraxia of Lid Opening Workup

Updated: Nov 10, 2023
  • Author: Marta Ugarte, MBBS, PhD, DPhil, FRCOphth; Chief Editor: Hampton Roy, Sr, MD  more...
  • Print

Approach Considerations

Neuroimaging studies using computed tomography (CT) scanning or magnetic resonance imaging (MRI) may help reveal whether a pathologic condition (eg, atrophy or infarct) is present in the cortex, basal ganglia, or rostral midbrain.

Positron emission tomography (PET) may be used to assess brain function by mapping glucose metabolism in neurons. PET studies of patients with apraxia of lid opening (ALO) have demonstrated glucose hypometabolism in the basal ganglia, [20] the medial frontal lobe (unilaterally or bilaterally), [20, 21] and the primary visual cortex, [21] suggesting abnormal neuronal activity.

Levator palpebrae superioris (LPS) and orbicularis oculi (OO) activity may be assessed by using electromyographic (EMG) recordings from these muscles during lid movements. Neuropsychological testing may reveal the presence or absence of frontal lobe pathology.