Blepharoclonus in Parkinson’s Disease: a prevalent and meaningful finding? (2174)

Objective: To assess the prevalence of blepharoclonus (eye lid fluttering) in patients with Parkinson’s disease (PD). If blepharoclonus is determined to be present in early PD stages, or if present in prodromal PD, then it may be a useful clinical diagnostic biomarker.

Background: Blepharoclonus elicited with gentle eyelid closure was reported with parkinsonism in congenital hydrocephalus, but has not reported in associated with PD. We have observed sustained eye lid fluttering upon gentle eye closure to be a common phenomenon in PD.

Design/Methods: We evaluated 20 consecutive new PD patients. We recorded patient’s age, sex, disease duration and Hoehn and Yahr (HY) stage. Blepharoclonus was considered present if eyelid fluttering was sustained for >5 seconds after gentle eye closure. For each patient we completed the REM Sleep Behavior Disorder Questionnaire (RBDQ), and recorded non motor features including anxiety, depression, subjective hyposmia/anosmia, and constipation. Eye lid fluttering was videotaped (examples embedded into poster).

Results: Of the 20 PD patients, 17 (85%) had sustained blepharoclonus. Our cohort included 6 (30%) women. Mean age was 67.1 years. Mean disease duration was 4.3 years. HY stages 1–5 are represented; HY1 (n=6; 30%), HY2 (n=11; 55%), HY3 (n=1; 5%), HY4 (n=1; 5%), and HY5 (n=1; 5%), and blepharoclonus was present in HY1 patients. 6 patients (30%) had RBDQ score >5 (suggestive for presence of RBD); 5 (83.3%) of these patients had blepharoclonus. Anosmia/hyposmia, constipation, anxiety and depression were present in 11 (55%), 11 (55%), 6 (30%) and 9 (45%), respectively.

Conclusions: Blepharoclonus is prevalent in PD, present in 85% of our cohort, including early PD stages, but it is not yet known if it is a potential prodromal symptom. To further investigate the utility of this finding as a prodromal diagnostic biomarker, its prevalence could be assessed in patients with idiopathic RBD without clinically apparent parkinsonism.

Disclosure: Dr. Margolesky has nothing to disclose. Dr. Fleming has nothing to disclose. Dr. Shpiner has nothing to disclose. Dr. Luca has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Abbott, Boston Scientific.. Dr. Moore has nothing to disclose. Dr. Singer has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with I have received payment for my work as a video panelist from CNS Ratings LLC reviewing videos for a Mitsubishi Pharmaceutical sponsored study.. Dr. Singer has received research support from Sunovion, Adamas, Pharma2B, Biogen.