Abstract
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.
Disputes & Debates: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.