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Eyelid tremor in a patient with a unilateral paramedian thalamic lesion
  1. G J Jungehülsing,
  2. C J Ploner
  1. Klinik für Neurologie, Charité, Humboldt-Universität, Berlin, Germany
  1. Correspondence to:
 Dr G J Jungehülsing, Klinik für Neurologie, Charité, Schumannstr 20/21, D-10117 Berlin, Germany;


A patient with a circumscribed infarction of the right paramedian thalamus developed a tremor of both eyelids on voluntary eye closure. Co-registration of the magnetic resonance image to a stereotactic atlas of the human thalamus revealed that the lesion was confined to a small subgroup of paramedian nuclei, including the parvocellular part of the mediodorsal nucleus. It is concluded that this region provides inhibitory input to cortical and/or subcortical regions controlling eyelid movements. Voluntary eye closure may involve direct cortico-nuclear connections and indirect pathways through the paramedian thalamus, most probably through the mediodorsal nucleus.

  • eyelid movements
  • blepharospasm
  • mediodorsal nucleus
  • MDpc, mediodorsal nucleus
  • EOG, electro-oculography
  • EMG, electromyography
  • LP, levator palpebrae muscle
  • OO, oribicularis oculi muscle

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  • Competing interests: none declared.