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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After introducing the problem of blepharospasm, we report our experience on treatment with purified botulinum A toxin in 16 cases of blepharospasm, symptomatic in two and essential in 14, than had not responded to drugs. The changes in intensity and frequency of spasm after treatment were evaluated on a clinical scale and by review of videotapes. The beneficial effect appeared within a week in most patients, lasting from 6 to 28 weeks (mean 13), and reached the maximum at the third-seventh week. Mild spasms and female patients responded better. Repeated injections were followed by better response to the drug. Complications, exclusively local, were represented by transient corneal exposure, ptosis, lacrimation or diplopia.
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PMID:Beneficial effect of botulinum A toxin in blepharospasm: 16 months' experience with 16 cases. 322 Jul 8

The natural history and response to different treatments have been evaluated in 264 patients with blepharospasm. The mean age of onset was 55.8 years and there was a female preponderance of 1.8 to 1. Dystonia elsewhere was found in 78% of patients, usually in the cranial-cervical region, and appeared to follow a somatotopic progression. A family history of blepharospasm or dystonia elsewhere was found in 9.5% of cases, which suggests a genetic predisposition. Ocular lesions preceded the onset of blepharospasm in 12.1% of cases. The response to drugs was inconsistent, although initial improvement was experienced by one fifth of patients treated with anticholinergics. Twenty-nine bilateral facial nerve avulsion operations were performed with benefit in 27 cases; but recurrences appeared in 22, on average one year after surgery. Botulinum toxin injections were performed in 151 patients. Significant improvement was achieved in 118 cases. Mean duration of benefit was 9.2 weeks. Transient ptosis and diplopia were the commonest side effects.
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PMID:Blepharospasm: a review of 264 patients. 340 84

13 patients with hemifacial spasm and 19 patients with blepharospasm (essential blepharospasm or Meige syndrome) were treated with injection of botulinum A toxin in the eyelids. The effectiveness of this therapy is constant and the treatment offers relief to almost all patients. The response times for repeated treatment was 6 months for blepharospasm and 7 months for hemifacial spasm. Repeated injections were performed in several patients and gave the same improvement. Transient ptosis or diplopia were observed in 11 patients. Possible systemic side effects (respiratory trouble) were documented in two patients. Botulinum toxin injection is an effective treatment but the relief is usually temporary and repeated treatments are necessary.
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PMID:[Treatment of blepharospasm and facial hemispasm by injection of botulinum toxin]. 341 19

One hundred and one patients with idiopathic blepharospasm have been treated with injections of botulinum toxin A into the orbicularis oculi. Ten had previously had facial nerve avulsions and responded well, normal visual function being restored in the majority (7/10) for an average of 14 weeks. Without prior surgical treatment the response was more variable, but 71/91 regained normal or near normal vision. Older patients, those with a family history of the condition, and those without oromandibular dystonia responded slightly better. The severity of the blepharospasm, the length of the history, and spontaneous resolution of an episode of focal dystonia in the past had no influence on the outcome. Results were poor in the presence of an associated neurological disorder. Side effects, particularly a temporary partial ptosis, were common but were well tolerated. The average duration of improvement was eight weeks in men, nine in women, and there was no evidence of any increase in duration after multiple injections. Eighty nine patients continued with injections, 11 opted for surgical treatment, and one resumed drugs.
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PMID:Long-term results of treatment of idiopathic blepharospasm with botulinum toxin injections. 366 59

Forty-eight patients were given serial injections of botulinum toxin in their eyelids for treatment of eyelid spasm during a two-year interval. Ninety-four percent obtained relief of spasm from botulinum toxin injection. The duration of the spasm-free interval as well as the incidence of ptosis and of diplopia was dose dependent. The marked increase in the incidence of these side effects with only a small increase in the duration of the spasm-free interval, when a dose of 25 units per lid was used, leads the authors to conclude that this dose is too high and should not be used. Since diplopia was most commonly caused by paresis of the inferior oblique muscle, and since blepharospasm usually can be controlled by excising the upper lid protractors, further studies are required to determine whether lower lid injection is necessary and, if it is found to be so, whether injecting only the lateral portion of the lid would be adequate.
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PMID:Treatment of facial spasm with botulinum toxin. An interim report. 376 37

Within a period of 14 months 73 patients with idiopathic blepharospasm which could not be treated satisfactorily by any other form of therapy were treated by injections of botulin toxin. In 55 cases the follow-up period was sufficiently long to permit an evaluation. Thirty-five patients were temporarily completely free of complaints; in one patient there was no improvement. In the remaining cases there was a slight to distinct reduction in symptoms, which often cause severe suffering. The full effect of the drug lasted between 1 and 27 weeks (average 7.5 weeks). No systemic side-effects were observed; local side-effects (subcutaneous bleeding during injection, slight ptosis, intermittent diplopia) seen in 6 cases were of very minor significance.
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PMID:[Blepharospasm treatment with botulinum toxin (follow-up)]. 380 20

Twenty-six patients with essential blepharospasm were treated with botulinum toxin by injection. The onset of protractor weakness in all patients ranged from one to five days following treatment. Maximal weakness developed within 12 days. There was a variable and gradual return of protractor strength over eight to 29 weeks in most patients and, with it, a return of spasm. Twenty-five patients received some degree of functional relief following initial injection. In most patients, however, the post-injection result could not be stabilized and repeat injections have been necessary to control recurrent spasms. There was one treatment failure. Three patients treated by injection following previous neurectomy and myectomy appeared to have a reduced requirement for subsequent injections. Complications included transient ptosis in six patients and mild exposure symptoms in four patients. Extraocular muscle paresis did not occur. There were no systemic side effects from the botulinum toxin injections.
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PMID:Botulinum toxin for the treatment of essential blepharospasm. 380 85

Purified botulinum A exotoxin was used in the treatment of forty seven patients with benign essential blepharospasm, 11 patients with hemifacial spasm and 2 patients with age-related entropion. The treatment was effective in all three groups for an average of 3-4 months when symptoms recurred and repeated chemodenervation with toxin was needed. The commonest complication was transient ptosis with an overall frequency of 7.8%. This incidence increased to 11.1% with toxin doses higher than 25 units per orbicularis. The treatment was well accepted by the patients, who were subsequently able to return to pre-blepharospasm lifestyles.
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PMID:Botulinum toxin for benign essential blepharospasm, hemifacial spasm and age-related lower eyelid entropion. 381 64

Corrective surgery for senile ptosis under local anaesthesia as day cases was carried out on 162 patients. All had 10 to 14 mm resection of the levator complex with an attached 2 mm strip of tarsal plate, always via a conjunctival approach. If indicated, simultaneous blepharoplasty was also performed. To simplify the surgical and parasurgical management, the author has progressively introduced modifications in the techniques of local anaesthesia, and in the surgical technique. These enable clear and clean isolation of the various tissue planes. The local anaesthesia including facial nerve block is given at least 30 minutes pre-operatively to prevent blepharospasm. Orbital compression is applied to achieve orbital decongestion, and an hypotensive avascular surgical field. This coupled with the use of microsurgical instruments for surgery under 3 times spectacle magnification allows proper delineation of surgical planes. The average surgical time is 20 minutes. Patients are allowed home within 2 hours of surgery, are seen for first dressing at 48 hours, and then for suture removal on the 7th post-operative day. There have been no corneal or other complications in any patient. Suboptimal cosmetic results in 2 patients were corrected by further surgery under local anaesthesia as day cases.
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PMID:Day surgery management of senile ptosis. 385 76

Botulinum toxin type A creates temporary localised flaccid paralysis after injection into skeletal muscle. Thirty four patients with blepharospasm, of whom 28 also had the oromandibular dystonia syndrome, were treated with injections of botulinum toxin type A into the orbicularis oculi, and 28 showed functional improvement after the treatment. A high incidence of local side effects occurred, especially partial ptosis, which was well tolerated. There were no systemic side effects. The average period of relief was 2.5 months, increasing to 2.8 months after a second injection. Functional improvement was limited in patients with severe associated dystonia.
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PMID:Effect of treatment with botulinum toxin on neurogenic blepharospasm. 392 84


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