Ptotic lid elevation during contralateral head tilt

Congenital abnormal synkinesis involving the eyelid, which is well described in the Marcus Gunn jaw-winking phenomenon, also has been reported in association with axons intended for facial musculature, extraocular muscles, and the pupil. The subject of this report is a novel form in which the patient’s ptotic eyelid elevated only during contralateral head tilt when the patient was upright, suggesting a congenital abnormality within the otolith–oculomotor pathway.