The management of blepharospasm and hemifacial spasm. 1992

J S Elston
National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

The aetiology of blepharospasm and hemifacial spasm is different, but both produce involuntary eye closure and facial movements which do not respond to systemic drug treatment. The introduction of therapeutic focal muscle weakening with botulinum toxin injections in the early 1980s appeared to offer great promise in the management of these conditions. In this paper the results of botulinum toxin treatment of 234 patients with blepharospasm and 73 patients with hemifacial spasm over a 7-year period have been analysed. Most patients receive sustained benefit from repeated injections whilst side-effects become less frequent. A clinically recognisable subgroup of patients with blepharospasm respond poorly and may be better treated surgically.

UI MeSH Term Description Entries
D008297 Male Males
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D001763 Blepharoptosis Drooping of the upper lid due to deficient development or paralysis of the levator palpebrae muscle. Ptosis, Eyelid,Blepharoptoses,Eyelid Ptoses,Eyelid Ptosis,Ptoses, Eyelid
D001764 Blepharospasm Excessive winking; tonic or clonic spasm of the orbicularis oculi muscle. Blepharospasms
D001905 Botulinum Toxins Toxic proteins produced from the species CLOSTRIDIUM BOTULINUM. The toxins are synthesized as a single peptide chain which is processed into a mature protein consisting of a heavy chain and light chain joined via a disulfide bond. The botulinum toxin light chain is a zinc-dependent protease which is released from the heavy chain upon ENDOCYTOSIS into PRESYNAPTIC NERVE ENDINGS. Once inside the cell the botulinum toxin light chain cleaves specific SNARE proteins which are essential for secretion of ACETYLCHOLINE by SYNAPTIC VESICLES. This inhibition of acetylcholine release results in muscular PARALYSIS. Botulin,Botulinum Neurotoxin,Botulinum Neurotoxins,Clostridium botulinum Toxins,Botulinum Toxin,Neurotoxin, Botulinum,Neurotoxins, Botulinum,Toxin, Botulinum,Toxins, Botulinum,Toxins, Clostridium botulinum
D004172 Diplopia A visual symptom in which a single object is perceived by the visual cortex as two objects rather than one. Disorders associated with this condition include REFRACTIVE ERRORS; STRABISMUS; OCULOMOTOR NERVE DISEASES; TROCHLEAR NERVE DISEASES; ABDUCENS NERVE DISEASES; and diseases of the BRAIN STEM and OCCIPITAL LOBE. Double Vision,Polyopsia,Diplopia, Cortical,Diplopia, Horizontal,Diplopia, Intermittent,Diplopia, Monocular,Diplopia, Refractive,Diplopia, Unilateral,Diplopia, Vertical,Cortical Diplopia,Cortical Diplopias,Diplopias,Diplopias, Cortical,Diplopias, Horizontal,Diplopias, Intermittent,Diplopias, Monocular,Diplopias, Refractive,Diplopias, Unilateral,Diplopias, Vertical,Horizontal Diplopia,Horizontal Diplopias,Intermittent Diplopia,Intermittent Diplopias,Monocular Diplopia,Monocular Diplopias,Polyopsias,Refractive Diplopia,Refractive Diplopias,Unilateral Diplopia,Unilateral Diplopias,Vertical Diplopia,Vertical Diplopias,Vision, Double
D005152 Facial Muscles Muscles of facial expression or mimetic muscles that include the numerous muscles supplied by the facial nerve that are attached to and move the skin of the face. (From Stedman, 25th ed) Mimetic Muscles,Facial Muscle,Mimetic Muscle,Muscle, Facial,Muscle, Mimetic,Muscles, Facial,Muscles, Mimetic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013035 Spasm An involuntary contraction of a muscle or group of muscles. Spasms may involve SKELETAL MUSCLE or SMOOTH MUSCLE. Muscle Spasm,Muscular Spasm,Spasm, Ciliary Body,Spasm, Generalized,Ciliary Body Spasm,Ciliary Body Spasms,Generalized Spasm,Generalized Spasms,Muscle Spasms,Muscular Spasms,Spasm, Muscle,Spasm, Muscular,Spasms,Spasms, Ciliary Body,Spasms, Generalized,Spasms, Muscle,Spasms, Muscular

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