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  • Title: Botulinum toxin injection into Riolan's muscle: somatosensory 'trick'.
    Author: Inoue K, Rogers JD.
    Journal: Eur Neurol; 2007; 58(3):138-41. PubMed ID: 17622718.
    Abstract:
    We studied the effect of injecting botulinum toxin A (BTX-A) into the pars ciliaris--also known as Riolan's muscle--of patients with eyelid apraxia (ELA). Six patients with ELA were treated with injections of BTX-A into the region of Riolan's muscle at the medial and lateral portions of the upper and lower pretarsal orbicularis oculi. Clinical benefit was seen in all 6 patients, 2 of whom had previously been treated with conventional pretarsal injections of BTX-A and had not improved. BTX-A injections into Riolan's muscle are effective as treatment for ELA. The proposed mechanism is not that of muscle relaxation but rather modulation of the somatosensory cortex, similar to that of a 'sensory trick' in patients with dystonia.
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