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Hyperkinetic Movement Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Morales-Briceno Hugo, Victor S.C. Fung, Annu Aggarwal, Philip Thompson
Blepharospasm: Onset 60–70 years.Women more commonly affected than men.Family history in 10%.Orbicularis oculi spasm including pretarsal component.Eyelid motility disorders (levator inhibition) may be combined.Worse when reading, watching television, or in bright sunlight.Intense spasm results in functional blindness.Preceding complaints of gritty discomfort in eyes common.70% have oromandibular dystonia (Meige's syndrome).22% have cervical dystonia.Spontaneous remission in 10% during the first 5 years.
Levator denervation for upper lid retraction secondary to seventh nerve palsy
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
K. G. Boboridis, N. G. Ziakas, N. S. Georgiadis
Botulinum Toxin type A has been extensively used for the management of blepharospasm, hemifacial spasm, strabismus, involutional lower lid entropion and in cosmetic applications. Chemical denervation of the levator muscle has been reported for correction of disthyroid (Uddin & Davies 2002) upper lid retraction and total ptosis for cornea protection (Adams et al. 1987; Kirkness et al. 1988). Its use in the management of upper lid retraction from seventh nerve palsy has not been extensively documented (Putterman 1990).
The protective structures, including removal of an eye
Published in Mary E. Shaw, Agnes Lee, Ophthalmic Nursing, 2018
Blepharospasm is a condition that causes forceful, painful spasm eyelid closure resulting in difficulty in opening the eye. Photophobia is present and the condition is exacerbated by bright lights, stress and excessive movement around the person. It can cause the individual concerned to become socially isolated and unable to work. There may be some accompanying contraction of the lower facial muscles. Treatment is by injections of botulinum (Bowling 2015) into the orbicularis muscle. This is repeated every 2–3 months.
Atypical Blepharospasm with Oromandibular Dystonia Associated with Cerebral Amyloid Angiopathy
Published in Neuro-Ophthalmology, 2022
Andrew R. Carey, Neil R. Miller
Although no pathological cause or localisation has been identified in the majority of patients with blepharospasm, the masked facies of Parkinsonism and increased co-occurrence with multi-system atrophy, Lewy body disease, and progressive supranuclear palsy suggest that these conditions share a common mechanism involving dysregulation of the basal ganglia and thalamic dopaminergic pathways.8,9 Some authors have hypothesised that blepharospasm is characterised by a combination of dopamine and acetylcholine excess, whereas rigid hypokinetic disorders, such as Parkinsonism are associated with dopamine deficiency and acetylcholine excess; and hyperkinetic disorders such as Huntington’s disease and tic disorders are associated with dopamine excess and acetylcholine deficiency.10
Duration and onset of effect of incobotulinumtoxinA for the treatment of blepharospasm in botulinum toxin-naïve subjects
Published in Current Medical Research and Opinion, 2021
Dimos D. Mitsikostas, Andrzej Dekundy, Angelika Hanschmann, Michael Althaus, Astrid Scheschonka, Fernando Pagan, Joseph Jankovic
Local injections of botulinum neurotoxin type A (BoNT-A) are an effective and well-tolerated treatment for blepharospasm1–7. IncobotulinumtoxinA (Xeomin, Merz Pharmaceuticals GmbH) is a BoNT-A formulation free from complexing proteins8 that is approved in the United States and Europe for the treatment of blepharospasm, in previously BoNT-treated and toxin-naïve subjects9–11. With one well-controlled, Class I study1,2, incobotulinumtoxinA has received level B recommendation for the treatment of blepharospasm in the report of the Guideline Development Subcommittee of the American Academy of Neurology12.
Ocular injuries resulting from commercial cosmetic procedures
Published in Clinical and Experimental Optometry, 2020
Mabel K Yan, Enis Kocak, Kevin Yoong, Jonathan K Kam
Botulinum toxin is a potent neurotoxin which causes flaccid paralysis through the presynaptic blockade of acetylcholine release at the neuromuscular junction. Its first documented therapeutic use was in 1973, when Scott et al.1973 injected the toxin to treat paralytic strabismus. In ophthalmology, periocular botulinum toxin injections can be used to treat blepharospasm, facial spasm and lid retraction. However, the inadvertent discovery of the enhancing effect of the toxin on facial rhytids (wrinkles) has seen it become a popular cosmetic treatment. Its periocular cosmetic use includes injections for glabellar, forehead and lateral canthal rhytids.2005