What Causes Droopy Eyelids?

Posted on Tue, 5 Jun 2018

Question: Dr Bishnoi

Still having problem with my lids closing even though I'm not tired.

Eyes have been checked several times within the last few months. Eyes are fine.

My neurologist had no real answer for me when I saw her three weeks ago

what would you recommend.

Thank you

Answered by Dr. Ishu Bishnoi (34 minutes later)

Brief Answer:
Eyelid apraxia - dystonia of Parkinson's

Detailed Answer:
Hi Bxxxxxxxx, thanks for asking from HCM and welcome back.

It is sad that your neurologist could not identify any significant cause. Has he ruled out all the mentioned causes like motor neurone disease, myopathy, progressive supra nuclear palsy? If yes, it leaves as with one rare phenomenon -

Eyelid apraxia due to dystonia of Parkinsonism.

In terms of the relationship between eyelid apraxia and Parkinson, apraxia and levodopa treatment have some relation. It has been found that eyelid apraxia might have occurred as an 'off' symptom or as a 'peak dose' effect of levodopa treatment in Parkinson disease.

I am providing you the reference of the paper - Clinical Analysis of Blepharospasm and Apraxia of Eyelid Opening in Patients with Parkinsonism. J Clin Neurol

Please ask your neurologist to go through it and adjust your dose of Sinimet (combination of levodopa and Carbidopa). That might help you.

If you have any doubt, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Prasad