Aberrant Facial Nerve Regeneration: an often-overlooked Neurogenic Cause of Blepharoptosis

Facial nerve palsy is a relatively common condition that is often idiopathic and usually recovers completely, but sometime there are subtle sequelae; one of these sequelae is blepharoptosis. The proposed mechanism is aberrant facial nerve regeneration resulting in increased orbicularis tone and/or synkinesis. A history of facial nerve palsy is rarely considered in patients presenting with blepharoptosis. Failure to suspect this etiology may lead to unnecessary testing and ineffective treatment.