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Toxins Apr 2020Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of... (Review)
Review
Blepharospasm and oromandibular dystonia are focal dystonias characterized by involuntary and often patterned, repetitive muscle contractions. There is a long history of medical and surgical therapies, with the current first-line therapy, botulinum neurotoxin (BoNT), becoming standard of care in 1989. This comprehensive review utilized MEDLINE and PubMed and provides an overview of the history of these focal dystonias, BoNT, and the use of toxin to treat them. We present the levels of clinical evidence for each toxin for both, focal dystonias and offer guidance for muscle and site selection as well as dosing.
Topics: Blepharospasm; Botulinum Toxins; Dystonic Disorders; Humans; Mandibular Diseases; Muscular Diseases; Neuromuscular Agents
PubMed: 32331272
DOI: 10.3390/toxins12040269 -
Movement Disorders : Official Journal... Apr 2017Forty years ago, C.D. Marsden proposed that blepharospasm should be considered a form of adult-onset focal dystonia. In the present paper, we provide a comprehensive... (Review)
Review
Forty years ago, C.D. Marsden proposed that blepharospasm should be considered a form of adult-onset focal dystonia. In the present paper, we provide a comprehensive overview of the findings regarding blepharospasm reported in the past 40 years. Although prolonged spasms of the orbicularis oculi muscles remain the clinical hallmark of blepharospasm, patients with blepharospasm may be characterized by various types of involuntary activation of periocular muscles. In addition to motor features, blepharospasm patients may also have nonmotor manifestations, including psychiatric, mild cognitive, and sensory disturbances. The various motor and nonmotor symptoms are not present in all patients, suggesting that blepharospasm is phenomenologically a heterogeneous condition. This emphasizes the need for tools for severity assessment that take into account both motor and nonmotor manifestations. The cause of blepharospasm remains elusive, but several lines of evidence indicate that blepharospasm is a multifactorial condition in which one, or several, as yet unknown genes together with epigenetic and environmental factors combine to reach the threshold of the disease. Although blepharospasm was originally believed to be solely a basal ganglia disorder, neurophysiological and neuroimaging evidence point to anatomical and functional involvement of several brain regions. The contribution of multiple areas has led to the hypothesis that blepharospasm should be considered as a network disorder, and this might reflect the varying occurrence of motor and nonmotor manifestations in blepharospasm patients. Despite advances in the aetiology and pathophysiology, treatment remains symptomatic. © 2017 International Parkinson and Movement Disorder Society.
Topics: Blepharospasm; Cognition Disorders; Humans; Longitudinal Studies; Mental Disorders; Movement Disorders; Prevalence; Sleep Wake Disorders
PubMed: 28186662
DOI: 10.1002/mds.26934 -
International Ophthalmology Clinics 2018
Review
Topics: Blepharospasm; Botulinum Toxins; Diagnosis, Differential; Hemifacial Spasm; Humans; Neurotoxins
PubMed: 29239872
DOI: 10.1097/IIO.0000000000000210 -
Seminars in Ophthalmology May 2010Essential blepharospasm is defined as the involuntary spasmodic bilateral closing of the eyelids. The symptoms are typically triggered by stress, fatigue, intense light,... (Review)
Review
Essential blepharospasm is defined as the involuntary spasmodic bilateral closing of the eyelids. The symptoms are typically triggered by stress, fatigue, intense light, or individual factors. The disease is usually slowly progressive. Essential blepharospasm is predominant in females and often appears in people older than 50 years old. At advanced stages patients develop functional blindness as well as social withdrawal. There are several treatment modalities: systemic and ocular medications, surgical procedures, and botulinum toxin (BTX). A great variety of drugs have been recommended for treating essential blepharospasm with poor results. Surgical procedures should be limited to the rare patients that do not respond to botulinum toxin treatment. BTX administration has been an effective treatment and should be considered the first choice for essential blepharospasm. The application technique, efficacy and possible complications are discussed in this paper.
Topics: Blepharospasm; Humans
PubMed: 20590421
DOI: 10.3109/08820538.2010.488564 -
Neurology Nov 2002Benign essential blepharospasm is a common focal dystonia characterized by involuntary eyelid closure. Its etiology, supported by animal models, appears to be... (Review)
Review
Benign essential blepharospasm is a common focal dystonia characterized by involuntary eyelid closure. Its etiology, supported by animal models, appears to be multifactorial, representing the influence of a genetic background and an environmental trigger. The genetic background could be responsible for the reduced brain inhibition, identified with physiologic studies that would set up a permissive condition for increased brain plasticity. Reduced D2 receptors identified with PET might be an indicator of this reduced inhibition. The trigger could be repetitive use or local ocular disease. Although symptomatic therapy is available, better approaches are needed and will likely become available as the genetics and pathophysiology become well understood.
Topics: Animals; Blepharospasm; Humans; Neuronal Plasticity
PubMed: 12434791
DOI: 10.1212/01.wnl.0000027361.73814.0e -
International Ophthalmology Clinics 2018
Review
Topics: Blepharospasm; Eyelids; Genetic Testing; Humans; Neuroimaging; Neurotoxins; Ophthalmologic Surgical Procedures
PubMed: 29239874
DOI: 10.1097/IIO.0000000000000207 -
International Ophthalmology Clinics 2018
Review
Topics: Blepharospasm; Blinking; Botulinum Toxins; Conjunctivitis; Humans; Injections; Keratitis
PubMed: 29239879
DOI: 10.1097/IIO.0000000000000205 -
International Ophthalmology Clinics 2005
Review
Topics: Blepharoplasty; Blepharospasm; Botulinum Toxins, Type A; Humans; Neuromuscular Agents
PubMed: 15970766
DOI: 10.1097/01.iio.0000167238.26526.a8 -
Nepalese Journal of Ophthalmology : a... Jan 2020
Topics: Blepharospasm; Botulinum Toxins, Type A; Humans
PubMed: 32799233
DOI: 10.3126/nepjoph.v12i1.25759 -
Current Opinion in Ophthalmology Sep 2013Botulinum toxin (BTX) injections are the main medical treatment of facial dystonias, but injections are ineffective in some patients. This review discusses the... (Review)
Review
PURPOSE OF REVIEW
Botulinum toxin (BTX) injections are the main medical treatment of facial dystonias, but injections are ineffective in some patients. This review discusses the indications for myectomy and surgical technique for treating benign essential blepharospasm (BEB) and apraxia of eyelid opening (ALO).
RECENT FINDINGS
There are four reasons to consider myectomy for patients with BEB. The first is ALO associated with BEB. The second is patients with blepharospasm-associated deformities. The third is patients who are truly unresponsive to BTX. The fourth is patients who cannot afford or who refuse BTX injections.
SUMMARY
Myectomy remains essential for treating blepharospasm patients and the most common indication is those with associated ALO.
Topics: Apraxias; Blepharospasm; Humans; Oculomotor Muscles; Ophthalmologic Surgical Procedures
PubMed: 23925062
DOI: 10.1097/ICU.0b013e3283645aee