Two Cases of Synkinetic Oculopalpebral Phenomena

ABSTRACT

Several synkinetic oculopalpebral phenomena were described in the literature in relation to ophthalmoplegias, congenital as well as acquired. Several neurologic explanations have been offered to explain their occurrence, but the entity of the phenomenon is not well clarified yet. From the study of the cases, where the third cranial nerve showed a palsy, some observations appear to be significant. This was present in both cases. In each the affected eye was divergent in the primary position. When the contralateral sound eye was covered the divergent affected eye moved medially to assume fixation, the sound eye showed an exag-gerated secondary deviation behind the occluder and at the same time, the ptotic lid showed an elevation, making the palpebral aperture wider. Adduction of the affected eye was retricted and on atttmption it widtning of the palpebral aperature indicated the occurrence of Fuchs phenomenon, the sound eye being markedly abducted. On abduction the palpebral aperture of the affected eye became narrower due to an increased ptosis. The author quoted Gowers stating the possibility of the overflow of in voluntary impulses carried by one nerve from its usual channels into another giving rise to the phenomenon. On abduction, the size of pupil became wider due to an increased ptosis. It can be deduced to be over-impulses of parasympathetic nerve. Two cases of ophthalmoplegias are described in this paper and it is hoped that the conelusions drawn therefrom may throw some light on this matter.