Collier's sign
Collier's sign (also known as Collier's tucked lid sign[1] or posterior fossa stare[2]) is bilateral or unilateral eyelid retraction.
| Collier's sign | |
|---|---|
| Symptoms | The sclera can be seen above the cornea, and further upgaze increases the distance between the eyelids and irises. |
| Causes | Upper dorsal midbrain supranuclear lesions such as Parinaud's syndrome, 'top of the basilar syndrome', midbrain infarction, neurodegeneration or tumour, multiple sclerosis, encephalitis, and Miller-Fisher syndrome. Damage to the posterior commissure levator inhibitory fibres which originate in the M-group of neurons. |
| Differential diagnosis | Midbrain lesion |
It is an accepted medical sign of a midbrain lesion, first described in 1927 by J Collier.[3] With the eyes in the primary position, the sclera can be seen above the cornea, and further upgaze increases the distance between the eyelids and irises.[4] Causes include upper dorsal midbrain supranuclear lesions such as Parinaud's syndrome, 'top of the basilar syndrome',[2] midbrain infarction, neurodegeneration or tumour, multiple sclerosis, encephalitis, and Miller-Fisher syndrome.[5] The cause is thought to be damage to the posterior commissure levator inhibitory fibres[2] which originate in the M-group of neurons.[4]
References
- "Colliers sign". biology-online.org. 2019-10-07.
- Larner, Andrew J. (2010). A Dictionary of Neurological Signs. Springer Publishing. doi:10.1007/978-1-4419-7095-4. ISBN 978-1-4419-7094-7. (subscription required)
- J. Collier, Nuclear Ophthalmoplegia with special reference to retraction of the lids and ptosis and to lesions of the posterior commissure. Brain (journal) 1927; 50; 488 - 498.
- Wray. "Supranuclear Paralysis of Upgaze".
- Miyashi M et al., Rinsho Shinkeigaku. 2006 Oct;46(10):712-4