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
- 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.