PM&R Meeting Abstracts

Official abstracts site for the AAPM&R Annual Assembly and the PM&R Journal.

MENU 
  • Home
  • Meetings Archive
    • AAPM&R Annual Assembly 2022
    • AAPM&R Annual Assembly 2021
    • AAPM&R Annual Assembly 2020
    • AAPM&R Annual Assembly 2019
  • Resources
  • Advanced Search

Apraxia of Eyelid Opening in Acute Ischemic Stroke: A Case Report

Nicholas C. Elwert, DO (University of Kentucky College of Medicine PM&R Program, Lexington, Kentucky); Jessica Kavanaugh, MD; Jonathan LeCrone, BS/BA

Meeting: AAPM&R Annual Assembly 2020

Categories: Neurological Rehabilitation (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Nicholas C. Elwert, DO: No financial relationships or conflicts of interest

Case Description: A 49-year-old Hispanic male who presented to the acute care hospital as a transfer with an acute ischemic stroke status post thrombectomy, with left internal carotid artery dissection and failed stent placement. Computed tomography of the head demonstrated significant cerebral edema with rightward midline shift requiring hemicraniectomy. Magnetic Resonance Imaging showed a large left MCA territory infarct involving the medial and inferior frontal gyri, basal ganglia, and the temporal and parietal lobes. Upon admission to acute rehabilitation, the patient presented with right-sided hemineglect and hemiplegia. Additionally, the patient presented with an inability to voluntarily open his eyes bilaterally which was determined to be apraxia of eyelid opening (AEO). After review of the pathophysiology of AEO, he was started on carbidopa/levodopa therapy.

Setting: Inpatient Rehabilitation Facility

Patient: A 49-year-old male with apraxia of eyelid opening in acute ischemic stroke Assessment/

Results: The day after carbidopa/levodopa initiation, he voluntarily opened his eyes on command. After three doses (10mg/100mg), he was able to open and close his eyes at will for five minute intervals. The dose was increased to 25mg/250mg after five days and the patient progressed to being able to open and close his eyes at will throughout his therapy sessions. At discharge, he was able to open and close his eyes throughout the majority of the day.

Discussion: AEO is defined as a non-paralytic inability to voluntarily open the eyes. It is most commonly described in patients with extrapyramidal diseases. However, in cases where there is association with cerebral infarct, lesions typically occurred in the basal ganglia. It is thought the primary motor cortex, the supplementary motor and the basal ganglia are involved in eyelid opening.

Conclusion: This case shows that AEO can occur after acute ischemic stroke of the basal ganglia, in the absence of extrapyramidal diseases, and can be successfully treated with dopaminergic medications.

Level of Evidence: Level V

To cite this abstract in AMA style:

Elwert NC, Kavanaugh J, LeCrone J. Apraxia of Eyelid Opening in Acute Ischemic Stroke: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/apraxia-of-eyelid-opening-in-acute-ischemic-stroke-a-case-report/. Accessed June 5, 2025.
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to AAPM&R Annual Assembly 2020

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/apraxia-of-eyelid-opening-in-acute-ischemic-stroke-a-case-report/

Leading the Way. Baltimore, MD & Virtual. October 20-23, 2022. #aapmr22

PM&R Journal

View issues of PM&R on the Wiley Online Library »

American Academy of Physical Medicine and Rehabilitation

Visit the official site for the American Academy of Physical Medicine and Rehabilitation »

AAPM&R Annual Assembly

Visit the official site for the AAPM&R Annual Assembly »

  • Help & Support
  • About Us
  • Cookies & Privacy
  • Wiley Job Network
  • Terms & Conditions
  • Advertisers & Agents
Copyright © 2025 John Wiley & Sons, Inc. All Rights Reserved.
Wiley