From the Research
Limited eyelid closure resulting from brainstem compression by a mass can be considered a craniopathy, as it affects the cranial nerves, specifically the facial nerve (cranial nerve VII) responsible for eyelid closure. This condition is a form of facial nerve palsy, which prevents complete eyelid closure (lagophthalmos) due to compression of the facial nerve nucleus or the nerve itself in the brainstem region 1. The brainstem houses the facial nerve nucleus, and the nerve exits near the cerebellopontine angle, making it vulnerable to compression from masses in this area, which interrupts the neural signals controlling the orbicularis oculi muscle responsible for eyelid closure. Some key points to consider in the management of this condition include:
- Prompt medical attention is necessary to address the underlying mass and prevent corneal complications
- Management may involve surgical removal, radiation, or other treatments depending on the mass type
- Eye protection through artificial tears, lubricating ointments, moisture chambers, or temporary tarsorrhaphy may be necessary to prevent corneal exposure, dryness, ulceration, and potential vision loss 2. It is essential to note that prolonged eyelid closure can put the cornea at risk, and conditions such as hypoxia or reduced tear volume can serve as risk factors for various corneal entities 3. In clinical practice, the most critical consideration is the potential for significant morbidity and mortality associated with brainstem compression and cranial nerve dysfunction, emphasizing the need for prompt and effective management 4.