The important role of family members in guiding medical professions to reach a diagnosis: Case report of under-noticed bilateral apraxia of eyelid closure

Abstract

Apraxia of eyelid closure (AEC) is a rare disorder characterized by the inability to close the eyes on command with the preservation of the motor and sensory systems, coordination, comprehension, and cooperation. The prevalence of AEC is extremely small and the exact pathophysiological mechanisms underlying this condition remain unknown. It is, however, associated with extrapyramidal disorders. Very few cases of bilateral AEC have been reported. We report a case of an 81-year-old male patient having multiple comorbidities including neurological, respiratory, and abnormalities complicated by COVID-19 infection, who developed AEC that was noticed by the caregiver. We illustrate the clinical course leading to the diagnosis of bilateral AEC and highlight the important role of the caregiver in reporting subtle signs such as AEC.

Keywords

• apraxia of eyelid closure
• eyelid disorders
• neurodegeneration
• parkinson’s disease
• progressive supranuclear palsy