Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-26T14:23:37.269Z Has data issue: false hasContentIssue false
  • English
  • Français

Botulinum Toxin Injections in the Treatment of Blepharospasm, Hemifacial Spasm, and Eyelid Fasciculations

Published online by Cambridge University Press:  18 September 2015

Stephen P. Kraft  and
Anthony E. Lang
Stephen P. Kraft*
Affiliation:
Department of Ophthalmology, University of Toronto and the Movement Disorders Clinic, Toronto Western Hospital, Toronto
Anthony E. Lang
Affiliation:
Department of Ophthalmology, University of Toronto and the Movement Disorders Clinic, Toronto Western Hospital, Toronto
*
Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Seventy-six patients with blepharospasm (mean age 56.9 years) received 248 injection treatments with botulinum A exotoxin (mean 3.1 treatments per patient): 87.0% of treatments led to total relief of spasms for a mean interval of 14.1 weeks. The average duration of response remained fairly constant over the first six injection series, although patients with the most severe spasms had shorter intervals than patients with less severe symptoms. Twenty patients with hemifacial spasm (mean age 56.9 years) received 44 treatments (mean 1.9 treatments per patient): In 93.1% of cases there was total relief of periocular and perioral spasms, with a mean interval of 17.4 weeks. The average duration of response for the third series of treatments was much shorter than the mean durations for the first two treatments. Side effects were always transient and included ptosis (23.3%), dry eyes (18.1%), tearing (5.5%), and strabismus (1.4%). No patient had a systemic reaction to the drug. Chronic benign eyelid fasciculations were also successfully treated in 3 patients with single treatments.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 15 , Issue 3 , August 1988 , pp. 276 - 280
Copyright
Copyright © Canadian Neurological Sciences Federation 1988

References

REFERENCES

1.Scott, AB.Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Ophthalmol Soc 1981; 79: 734–770.Google ScholarPubMed
2.Scott, AB, Kennedy, RA, Stubbs, HA.Botulinum A toxin injection as a treatment for blepharospasm. Arch Ophthalmol 1985: 103: 347–350.CrossRefGoogle ScholarPubMed
3.Elston, JS, Ross Russell, JW.Effect of treatment with botulinum toxin on neurogenic blepharospasm. Br Med J 1985; 290: 1857–1859.CrossRefGoogle ScholarPubMed
4.Cohen, DA, Savino, PJ, Stern, MB, et al. Botulinum injection therapy for blepharospasm: A review and report of 75 patients. Clin Neuropharmacol 1986: 9: 415–429.CrossRefGoogle ScholarPubMed
5.Frueh, BR. Felt, DP, Wojno, TH.et al. Treatment of blepharospasm with botulinum toxin: A preliminary report. Arch Ophthalmol 1984; 102: 1464–1468.CrossRefGoogle ScholarPubMed
6.Tsoy, EA, Buckley, EG, Dutton, JJ.Treatment of blepharospasm with botulinum toxin. Am J Ophthalmol 1985; 99: 176–179.CrossRefGoogle ScholarPubMed
7.Shorr, N, Sieff, SR, Kopelman, J.The use of botulinum toxin in blepharospasm. Am J Ophthalmol 1985; 99: 542–546.CrossRefGoogle ScholarPubMed
8.Frueh, BR, Musch, DC.Treatment of facial spasm with botulinum toxin: An interim report. Ophthalmology 1986; 93: 917–923.CrossRefGoogle ScholarPubMed
9.Biglan, AW, May, M.Treatment of facial spasm with Oculinum (C. botulinum toxin). J Ped Ophthalmol Strabismus 1986; 23: 216–221.CrossRefGoogle ScholarPubMed
10.Perman, KI, Baylis, HI, Rosenbaum, AL, et al. The use of botulinum toxin in the medical management of benign essential blepharospasm. Ophthalmology 1986; 93: 1–3.CrossRefGoogle ScholarPubMed
11.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.Google ScholarPubMed
12.Savino, PJ, Sergott, RC, Bosley, TM, et al. Hemifacial spasm treated with botulinum A toxin injection. Arch Ophthalmol 1985; 103: 1305–1306.CrossRefGoogle ScholarPubMed
13.Lingua, RW.Sequelae of botulinum toxin injection. Am J Ophthalmol 1985; 100: 305–307.CrossRefGoogle ScholarPubMed
14.Tsui, JK, Eisen, A, Mak, E, et al. A pilot study on the use of botulinum toxin in spasmodic torticollis, Can J Neurol Sci 1985; 12: 314–316.CrossRefGoogle ScholarPubMed
15.Tsui, JKC, Fross, RD, Calne, S, et al. Local treatment of spasmodic torticollis with botulinum toxin. Can J Neurol Sci 1987; 14: 533–535.CrossRefGoogle ScholarPubMed
16.Greene, P, Shale, H, Fahn, S, et al. Treatment of torticollis with injections of botulinum toxin [Abstract]. Neurology 1987; 37 (suppl 1): 123.Google Scholar
17.Ludlow, C, Hallett, M, Naunton, R, et al. Treatment of spasmodic dysphonia with botulinum toxin [Abstract]. Neurology 1987; 37 (suppl 1): 124.Google Scholar
18.Jankovic, J, Orman, J.Botulinum toxin for cranial-cervical dystonia: A double-blind controlled study [Abstract]. Neurology 1986; 36 (suppl 1): 120–121.Google Scholar
19.Brin, M, Fahn, S, Moskowitz, CB, et al. Injections of botulinum toxin for the treatment of focal dystonia [Abstract]. Neurology 1986; 36 (suppl 1): 120.Google Scholar
20.Cohen, L, Hallett, M, Geller, B, et al. Treatment of focal dystonias of the hand with botulinum toxin injection [Abstract]. Neurology 1987; 37 (suppl 1): 123.Google Scholar
21.Gillum, WN, Anderson, RL.Blepharospasm surgery: An anatomic approach; Arch Ophthalmol 1981; 99: 1056–1062.CrossRefGoogle Scholar
22.McCord, CD Jr, Coles, WH, Shore, JW, et al. Treatment of essential blepharospasm. I. Comparison of facial nerve avulsion and eyebrow-eyelid muscle stripping procedure. Arch Ophthalmol 1984; 102: 266–268.CrossRefGoogle ScholarPubMed
23.Surwit, RS, Rotberg, M.Biofeedback therapy of essential blepharospasm. Am J Ophthalmol 1984; 98: 28–31.CrossRefGoogle ScholarPubMed
24.Fahn, S, List, T, Moskowitz, C, et al. Double-blind controlled study of botulinum toxin for blepharospasm [Abstract]. Neurology 1985; 35 (suppl 1): 271.Google Scholar
25.Tsui, JK, Eisen, A, Stoessl, AJ, et al. Double-blind study of botulinum toxin in spasmodic torticollis. Lancet 1986; 2: 245–247.CrossRefGoogle ScholarPubMed
26.Sanders, DB, Massey, EW, Buckley, EG.Botulinum toxin for blepharospasm: Single-fibre EMG studies. Neurology 1986; 36: 545–547.Google Scholar
27.Lange, DJ, Brin, MF, Warner, CL, et al. Distant effects of local injection of botulinum toxin. Muscle & Nerve 1987; 10: 552–555.CrossRefGoogle ScholarPubMed
28.Biglan, AW, Gonnering, R, Lockhart, LB, et al. Absence of antibody production in patients treated with botulinum A toxin. Am J Ophthalmol 1986; 101: 232–235.CrossRefGoogle ScholarPubMed
29.Burns, CL, Gammon, JA, Gemmili, MC.Ptosis associated with botulinum toxin treatment of strabismus and blepharospasm. Ophthalmology 1986; 93: 1621–1627.CrossRefGoogle ScholarPubMed
30.Marsden, CD, Lang, AE, Sheehy, MP.The pharmacology of cranial dystonia. Neurology 1983; 33: 1100–1101.CrossRefGoogle ScholarPubMed
31.Jankovic, J, Ford, J.Blepharospasm and oro-facial dystonia: Clinical and pharmacologic findings in 100 patients. Ann Neurol 1983; 13: 402–411.CrossRefGoogle Scholar
32.Eckman, PB, Kramer, RA, Altrocchi, PH.Hemifacial spasm. Arch Neurol 1971; 25: 81–87.CrossRefGoogle ScholarPubMed
33.Jannetta, PJ, Abbasy, M, Maroon, JC, et al: Etiology and definitive microsurgical treatment of hemifacial spasm. J Neurosurg 1977; 47: 321–328.CrossRefGoogle ScholarPubMed
34.Jannetta, PJ.Hemifacial spasm: Treatment by posterior fossa surgery. J Neurol Neurosurg Psychiatry 1983; 46: 465.CrossRefGoogle ScholarPubMed
35.Iwakuma, T, Matsumoto, A, Nakamura, N.Hemifacial spasm: Comparison of three different operative procedures in 110 patients. J Neurosurg 1982; 57: 753–756.CrossRefGoogle ScholarPubMed