Skip to main content
SpringerLink
Log in

Blepharospasm

  • Chapter
Therapeutic Uses of Botulinum Toxin

Abstract

Blepharospasm is a focal dystonia of the orbicularis oculi muscles characterized by chronic intermittent or sometimes persistent involuntary eyelid closure (1). Blepharospasm usually begins in the fifth to sixth decade of life (mean age of 56) and has a slight female preponderance (1.8:1; refs. 2–7). The prevalence of blepharospasm is estimated at 5 per 100,000 individuals (3, 8), with approximately 50,000 cases occurring in the United States and with nearly 2000 new cases diagnosed annually.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Costa J, Espirito-Santo C, Borges A, Ferreira et al. Botulinum toxin type A therapy for blepharospasm. Cochrane Database Syst Rev 2005;l:CD004900.

    Google Scholar 

  2. Frueh BR, Callahan A, Dortzbach RK, et al. A profile of patients with intractable blepharospasm. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 1976;81:591–594.

    Google Scholar 

  3. Grandas F, Traba A, Alonso F, Esteban A. Blink reflex recovery cycle in patients with blepharospasm unilaterally treated with botulinum toxin. Clin Neuropharmacol 1998;21:307–311.

    PubMed  CAS  Google Scholar 

  4. Henderson JW. Essential blepharospasm. Trans Am Ophthalmol Soc 1956;54:453–520.

    PubMed  CAS  Google Scholar 

  5. Jankovic J, Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacology findings in 100 patients. Ann Neurol 1983;13:402–411.

    Article  PubMed  CAS  Google Scholar 

  6. Marsden CD. Blepharospasm-oromandibular dystonia syndrome. J Neurol Neurosurg Psychiatry 1976;390:1204–1209.

    Article  Google Scholar 

  7. Tolosa ES. Clinical features of Meige’s disease (idiopathic orofacial dystonia): a report of 17 cases. Arch Neurol 1981;36:147–151.

    Google Scholar 

  8. Nutt JG, Muenter MD, Melton LJ III, Aronson A, Kurland LT. Epidemiology of focal and generalized dystonia in Rochester, Minnesota. Mov Disord 1988;3:188–194.

    Article  CAS  Google Scholar 

  9. McCann JD, Gauthier M, Morschbacher R, et al. A novel mechanism for benign essential blepharospasm. Ophthal Plast Reconstr Surg 1999;15:384–389.

    PubMed  CAS  Google Scholar 

  10. Tolosa ES, Klawans HL. Meige’s disease: a clinical form of a facial convulsion, bilateral and medial. Arch Neurol 1979;36:635–637.

    PubMed  CAS  Google Scholar 

  11. Costa J, Espirito-Santo C, Borges A, et al. Botulinum toxin type A therapy for hemifacial spasm. Cochrane Database Syst Rev 2005;l:CD004899.

    Google Scholar 

  12. Anderson FL, Patel BCK, Holds JB, Jordan DR. Blepharospasm: past, present, future. Ophthal Plast Reconstr Surg 1998;15:305–317.

    Google Scholar 

  13. Herz NL, Yen MT. Modulation of sensory photophobia in essential blepharospasm with chromatic lenses. Ophthalmology 2005;112:2208–2211.

    Article  PubMed  Google Scholar 

  14. Harrison AR. Chemodenervation for facial dystonias and wrinkles. Curr Opin Ophthalmol 2003;14:241–245.

    Article  PubMed  Google Scholar 

  15. Aramideh M, Ongerboer de Visser BW, Vrans JW, Koelman JH, Speelman JD. Pretarsal application of botulinum toxin for treatment of blepharospasm. J Neurol Neurosurg Psychiatry 1995;59:309–311.

    Article  PubMed  CAS  Google Scholar 

  16. Klein AW. Dilution and storage of botulinum toxin. Dermatol Surg 1998;24:1179–1180.

    Article  PubMed  CAS  Google Scholar 

  17. Lowe NJ. Botulinum toxin A for facial rejuvenation: United States and United Kingdom Perspectives. Dermatol Surg 1998;24:1216–1218.

    Article  PubMed  CAS  Google Scholar 

  18. Hsu TS, Dover JS, Arndt KA. Effect of volume and concentration on the diffusion of botulinum exotoxin A. Arch Dermatol 2004;140:1351–1354.

    Article  PubMed  CAS  Google Scholar 

  19. Kowal L. Pretarsal injections of botulinum toxin improve blepharospasm in previously unresponsive patients. J Neurol Neurosurg Psychiatry 1997;63:556.

    Article  PubMed  CAS  Google Scholar 

  20. Mackie IA. Riolan’s muscle: action and indications for botulinum toxin injection. Eye 2000; 14: 347–352.

    PubMed  Google Scholar 

  21. Jost WH, Kohl A. Botulinum toxin: evidence-based medicine criteria in blepharospasm and hemifacial spasm. J Neurol 2001;248:21–24.

    Article  PubMed  CAS  Google Scholar 

  22. Osako, Keltner JL. Botulinum A toxin (Oculinum) in ophthalmology. Surv Ophthalmol 1991; 36:28–46.

    Article  PubMed  CAS  Google Scholar 

  23. Katzung B. Basic & Clinical Pharmacology. Ninth ed. New York: McGraw-Hill; 2004.

    Google Scholar 

  24. Fahn S. Systemic therapy of dystonia. Can J Neurol Sci 1987;14:528–532.

    PubMed  CAS  Google Scholar 

  25. Defazio G, Lamberti P, Lepore V, et al. Facial dystonia: clinical features, prognosis and pharmacology in 31 patients. Ital J Neurol Sci 1989;10:553–560.

    PubMed  CAS  Google Scholar 

  26. Fahn S. High dosage anticholinergic therapy in dystonia. Neurology 1983;33:1255–1261.

    PubMed  CAS  Google Scholar 

  27. Burke RE, Fahn S, Marsden CD. Torsion dystonia: a double-blind, prospective trial of highdosage trihexyphenidyl. Neurology 1986;36:160–164.

    PubMed  CAS  Google Scholar 

  28. Hayashi T, Furutani M, Taniyama J, et al. Neuroleptic-induced Meige’s syndrome following akathisia: pharmacologie characteristics. Psychiatry Clin Neurosci 1998;52:445–448.

    Article  PubMed  CAS  Google Scholar 

  29. Astarloa R, Morales B, Penafiel N, et al. Craniocervical dystonia and facial hemispasm: clinical and pharmacological characteristics of 52 patients. Rev Clin Esp 1991;189:320–324.

    PubMed  CAS  Google Scholar 

  30. Ortiz A. Neuropharmacological profile of Meige’s disease: overview and a case report. Clinic Neuropharmacol 1983;6:297–304.

    CAS  Google Scholar 

  31. Duvoison RC. Meige syndrome: relief on high dose anti-cholingergic therapy. Clinic Neuropharmacol 1983;6:63–66.

    Google Scholar 

  32. Mezaki T, Hayashi A, Nakase H, et al. Therapy of dystonia in Japan. Rinsho Shinkeigaku 2005; 45:634–642.

    PubMed  Google Scholar 

  33. Jankovic J, Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients. Ann Neurol 1983;13:402–411.

    Article  PubMed  CAS  Google Scholar 

  34. Boghen DR, Lesser RL. Blepharospasm and Hemifacial Spasm. Curr Treat Options Neurol 2000;2:393–400.

    Article  PubMed  Google Scholar 

  35. Dowsey-Limousin P. Parkinsonian dystonia. Rev Neurol 2003;159:928–931.

    PubMed  CAS  Google Scholar 

  36. Tarsy D. Tardive Dyskinesia. Curr Treat Options Neurol 2000;2:205–214.

    Article  PubMed  Google Scholar 

  37. Ransmayr G, Kleedorfer B, Dierckx RA, et al. Pharmacological study in Meige’s syndrome with predominant blepharospasm. Clin Neuropharmacol 1988;11:68–76.

    Article  PubMed  CAS  Google Scholar 

  38. Hipola D, Mateo D, Gimenez-Roldan S. Meige’s syndrome: acute and chronic responses to clonazepan and anticholinergics. Eur Neurol 1984;23:474–478.

    Article  PubMed  CAS  Google Scholar 

  39. Jankovic J, Orman J. Botulinum A toxin for cranial-cervical dystonia: a double-blind, placebocontrolled study. Neurology 1987;37:616–623.

    PubMed  CAS  Google Scholar 

  40. Yoshimura R, Kakihara S, Soya A, et al. Effect of clonazepam treatment on antipsychotic drug-induced Meige syndrome and changes in plasma levels of GABA, HVA, and MHPG during treatment. Psychiatry Clin Neurosci 2001;55:543–546.

    Article  PubMed  CAS  Google Scholar 

  41. White MC, Silverman JJ, Harbison JW. Psychosis associated with clonazepam therapy for blepharospasm. J Nerv Ment Dis 1982; 170:117–119.

    Article  PubMed  CAS  Google Scholar 

  42. Papaterra Limongi JC. Dystonia: therapeutic aspects. Arq Neuropsiquiatr 1996;54:147–155.

    PubMed  CAS  Google Scholar 

  43. De Andrade LA, Bertolucci PH. Treatment of Meige disease with a GABA receptor agonist. Arq Neuropsiquiatr 1985;43:260–266.

    PubMed  Google Scholar 

  44. Wirtschafter JD. Clinical doxorubicin chemotherapy: an experimental treatment for benign essential blepharospasm and hemifacial spasm. Ophthalmology 1991;98:357–366.

    PubMed  CAS  Google Scholar 

  45. Sandyk R. Blepharospasm—successful treatment with baclofen and sodium valproate. A case report. S Afr Med J 1983;64:955–956.

    PubMed  CAS  Google Scholar 

  46. Srivastava T, Goyal V, Singh S, et al. Pallido-pyramidal syndrome with blepharospasm and good response to levodopa. J Neurol 2005;252:1537–1538.

    Article  PubMed  Google Scholar 

  47. Lee KC, Finley R, Miller B. Apraxia of lid opening: dose-dependent response to carbidopalevodopa. Pharmacotherapy 2004;24:401–403.

    Article  PubMed  Google Scholar 

  48. Dewey RB Jr, Maraganore DM. Isolated eyelid-opening apraxia: report of a new levodoparesponsive syndrome. Neurology 1994;44:1752–1754.

    PubMed  Google Scholar 

  49. Dowsey-Limousin P. Parkinsonian dystonia. Rev Neurol 2003;159:928–931.

    PubMed  CAS  Google Scholar 

  50. Barclay CL, Lang AE. Dystonia in progressive supranuclear palsy. J Neurol Neurosurg Psychiatry 1997;62:352–356.

    Article  PubMed  CAS  Google Scholar 

  51. Lamberti P, De Mari M, Zenzola A, et al. Frequency of apraxia of eyelid opening in the general population and in patients with extrapyramidal disorders. 2002;23:S81–S82.

    Google Scholar 

  52. Grandas F, Elston J, Quinn N, et al. Pharmacologic, surgical and infiltration of botulin toxin treatment in blepharospasm. Neurologia 1989;4:194–199.

    PubMed  CAS  Google Scholar 

  53. Arthurs B, Flanders M, Codere F, et al. Treatment of blepharospasm with medication, surgery and type A botulinum toxin. Can J Ophthalmol 1987;22:24–28.

    PubMed  CAS  Google Scholar 

  54. Grivet D, Robert PY, Thuret G, et al. Assessment of blepharospasm surgery using an improved disability scale: study of 138 patients. Ophthal Plast Reconstr Surg 2005;21:230–234.

    Article  PubMed  Google Scholar 

  55. Yanoff M, Duker JS. Ophthalmology. Second ed. St. Louis, MO: Mosby; 2004.

    Google Scholar 

  56. McCann JD, Ugurbas SH, Goldberg RA. Benign essential blepharospasm. Int Ophthalmol Clin 2002;42:113–121.

    PubMed  Google Scholar 

  57. Yen MT, Anderson RL, Small RG. Orbicularis oculi muscle graft augmentation after protractor myectomy in blepharospasm. Ophthal Plast Reconstr Surg 2003;19:287–296.

    Article  PubMed  Google Scholar 

  58. Topaloglu H, Serdaroglu A, Okan M, et al. Improvement of myotonia with carbamazepine in three cases with the Schwartz-Jampel syndrome. Neuropediatrics 1993;24:232–234.

    Article  PubMed  CAS  Google Scholar 

  59. Wirtschafter JD, McLoon LK. Long-term efficacy of local doxorubicin chemomyectomy in patients with blepharospasm and hemifacial spasm. Ophthalmology 1998;105:342–346.

    Article  PubMed  CAS  Google Scholar 

  60. Fante RG, Frueh BR. Differential section of the seventh nerve as a tertiary procedure for the treatment of benign essential blepharospasm. Ophthal Plast Reconstr Surg 2001; 17:276–280.

    Article  PubMed  CAS  Google Scholar 

  61. Wakakura M, Tsubouchi T, Inouye J. Etizolam and benzodiazepine induced blepharospasm. J Neurol Neurosurg Psychiatry 2004;75:506–507.

    Article  PubMed  CAS  Google Scholar 

  62. Klein RL, Harris RA. Regulation of GABAA receptor structure and function by chronic drug treatments in vivo and with stably transfected cells. Jpn J Pharmacology 1996;70:1–15.

    Article  CAS  Google Scholar 

  63. Pikielny RT, Micheli FE, Fernandez Pardal MM, et al. Treatment of blepharospasm with botulinum toxin. Medicina 1990;50:129–134.

    PubMed  CAS  Google Scholar 

  64. McLoon LK, Wirtschafter JD. Doxil-induced chemomyectomy: effectiveness for permanent removal of orbicularis oculi muscle in monkey eyelid. Invest Ophthalmol Vis Sci 2001; 42:1254–1257.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. Amir Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc J. Spirn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Khoramian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Robert Bernardino
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Physical Medicine and Rehabilitation New York Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY

    Grant Cooper MD

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Humana Press Inc.

About this chapter

Cite this chapter

Cohen, A., Spirn, M.J., Khoramian, D., Bernardino, C.R. (2007). Blepharospasm. In: Cooper, G. (eds) Therapeutic Uses of Botulinum Toxin. Humana Press. https://doi.org/10.1007/978-1-59745-247-2_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-247-2_14

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-914-7

  • Online ISBN: 978-1-59745-247-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation