Aim: To elicit various presentations of oculomotor synkinesis a/w ptosis. Method: Retrospective analysis of 4 cases of oculomotor synkinesis is presented here. 2 patients had ptosis a/w oculomotor-trigeminal synkinesis who were found to have elevation of UL with jaw movements (MGJWP). 3rd patient had oculomotor synkinesis presenting as widening of palpebral aperture on adduction (Pseudo von-grafae sign). 4th patient had ptosis a/w oculomotor-facial synkinesis presenting as elevation of UL on smiling. Results: Pts underwent detailed ocular examination & were planned for LPS excision with frontalis sling. Conclusion: Oculomotor synkinesis is abnormal response to firing of oculomotor nerve causing paradoxical co-contraction of muscles. It can occur with or without preceding oculomotor nerve dysfunction. Treatment startegies vary depending on individual clinical presentation & thus synkinesis need to be taken into consideration for surgical planning.
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