Dr. Bhagwati Wadwekar, W09478
Aberrant facial nerve regeneration (AFR) is a not well recognized as a cause of ptosis. Signs of AFR includes prominent nasolabial fold on side of paralysis, ptosis and narrow palpebral aperture.
We present a case of fifty year old lady with complaint of gradual onset drooping of left eye upperlid since 6months. Left eye margin Reflex distance1 was -1 mm and margin reflex distance2 was 4.5mm . Amount of ptosis left eye was 5.5 mm. Levator palpebrae superioris(LPS) action was 12mm. Extra ocular movement were full in all the gazes. She had good bells phenomena. Ice pack test was negative. Pupillary examination was normal. We noticed that ptosis increased with jaw movements. Corneal sensation were normal and Schirmer’s test was 20mm . On further examination she had old lower motor neuron(LMN) facial paralysis on left side. She had narrow palpebral aperture which further narrowed on Jaw movements. Patient was diagnosed as left side old LMN facial paralysis with severe ptosis due to AFR.
In conclusion, AFR as a cause of pt