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Abstract Details

Blepharoclonus in Parkinson’s Disease: a prevalent and meaningful finding?
Movement Disorders
P11 - Poster Session 11 (8:00 AM-9:00 AM)
3-017
To assess the prevalence of blepharoclonus (eye lid fluttering) in patients with Parkinson’s disease (PD). If blepharoclonus is determined to be present in early PD stages, or if present in prodromal PD, then it may be a useful clinical diagnostic biomarker. 
Blepharoclonus elicited with gentle eyelid closure was reported with parkinsonism in congenital hydrocephalus, but has not reported in associated with PD. We have observed sustained eye lid fluttering upon gentle eye closure to be a common phenomenon in PD.
We evaluated 20 consecutive new PD patients. We recorded patient’s age, sex, disease duration and Hoehn and Yahr (HY) stage. Blepharoclonus was considered present if eyelid fluttering was sustained for >5 seconds after gentle eye closure. For each patient we completed the REM Sleep Behavior Disorder Questionnaire (RBDQ), and recorded non motor features including anxiety, depression, subjective hyposmia/anosmia, and constipation. Eye lid fluttering was videotaped (examples embedded into poster).  
Of the 20 PD patients, 17 (85%) had sustained blepharoclonus. Our cohort included 6 (30%) women. Mean age was 67.1 years. Mean disease duration was 4.3 years. HY stages 1-5 are represented; HY1 (n=6; 30%), HY2 (n=11; 55%), HY3 (n=1; 5%), HY4 (n=1; 5%), and HY5 (n=1; 5%), and blepharoclonus was present in HY1 patients. 6 patients (30%) had RBDQ score >5 (suggestive for presence of RBD); 5 (83.3%) of these patients had blepharoclonus. Anosmia/hyposmia, constipation, anxiety and depression were present in 11 (55%), 11 (55%), 6 (30%) and 9 (45%), respectively. 
Blepharoclonus is prevalent in PD, present in 85% of our cohort, including early PD stages, but it is not yet known if it is a potential prodromal symptom. To further investigate the utility of this finding as a prodromal diagnostic biomarker, its prevalence could be assessed in patients with idiopathic RBD without clinically apparent parkinsonism. 
Authors/Disclosures
Jason H. Margolesky, MD, FÂ鶹´«Ã½Ó³»­ (University of Miami School of Medicine)
PRESENTER 		Dr. Margolesky has nothing to disclose.
Nicholas J. Fleming, MD (Atrium Neurosciences Institute) Dr. Fleming has nothing to disclose.
Danielle S. Shpiner, MD An immediate family member of Dr. Shpiner has received personal compensation for serving as an employee of University of Miami. Dr. Shpiner has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Mission MSA. The institution of Dr. Shpiner has received research support from American Parkinson's Disease Association. The institution of Dr. Shpiner has received research support from CurePSP. The institution of Dr. Shpiner has received research support from Parkinson's Foundation. Dr. Shpiner has a non-compensated relationship as a COE Medical Director with Parkinson's Foundation that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Medtronic that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Boston Scientific that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Abbott that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Abbvie that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Ipsen that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Amneal that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Michael J. Fox Foundation that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a CoC Medical Director with CurePSP that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a COE Medical Director with Mission MSA that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Shpiner has a non-compensated relationship as a Fellowship Co-Director with Merz that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Corneliu C. Luca, MD (University of Miami) Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Luca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Signant Health. Dr. Luca has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott.
Henry P. Moore, MD (University of Miami - Miller School of Medicine) Dr. Moore has received personal compensation in the range of $0-$499 for serving as a Consultant for Abbvie. Dr. Moore has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ipsen Pharma. The institution of Dr. Moore has received research support from Sage Therapeutics. The institution of Dr. Moore has received research support from Bukwang Pharmaceutical. The institution of Dr. Moore has received research support from Neurocrine. The institution of Dr. Moore has received research support from CDHI Foundation. The institution of Dr. Moore has received research support from MODUS Outcomes LLC. The institution of Dr. Moore has received research support from University of Kansas Center for Research.
Carlos Singer, MD (University of Miami) Dr. Singer has nothing to disclose.