Apraxia of Lid Opening

Apraxia of lid opening is a nonparalytic motor abnormality characterized by the patient's difficulty in initiating the act of lid elevation. It differs from paralytic ptosis by being present only momentarily at the start of lid opening, and it differs from ordinary forms of blepharospasm by occurring without unusual contraction of the orbicularis oculi. Although apraxia of lid closure has long been documented in the literature (Lewandowsky, 1907),1apraxia of lid opening has scarcely been mentioned. Schilder (1927)2described it, however, in two patients who had difficulty with both opening and closing their eyes. One of these patients had Huntington's chorea and both patients developed a trick of opening their eyes by a thrust of their heads backward. Riese (1930)3described apraxia of lid opening in a patient with a bullet injury to his frontotemporal region. We have not found other reports of this abnormality but suspect