Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Chapter 1 The pretherapeutic history of botulinum neurotoxin
- Chapter 2 Botulinum neurotoxin: history of clinical development
- Chapter 3 Pharmacology of botulinum neurotoxins
- Chapter 4 Immunological properties of botulinum neurotoxins
- Chapter 5 Treatment of cervical dystonia
- Chapter 6 Examination and treatment of complex cervical dystonia
- Chapter 7 Ultrasound guidance for botulinum neurotoxin therapy: cervical dystonia
- Chapter 8 Treatment of blepharospasm
- Chapter 9 Botulinum neurotoxin in oromandibular dystonia
- Chapter 10 Treatment of focal hand dystonia
- Chapter 11 Botulinum neurotoxin therapy of laryngeal muscle hyperactivity syndromes
- Chapter 12 The use of botulinum neurotoxin in otorhinolaryngology
- Chapter 13 Treatment of hemifacial spasm
- Chapter 14 Spasticity
- Chapter 15 The use of botulinum neurotoxin in spastic infantile cerebral palsy
- Chapter 16 The role of ultrasound for botulinum neurotoxin injection in childhood spasticity
- Chapter 17 The use of botulinum neurotoxin in spasticity using ultrasound guidance
- Chapter 18 The use of botulinum neurotoxin in tic disorders and essential hand and head tremor
- Chapter 19 Treatment of stiff-person syndrome with botulinum neurotoxin
- Chapter 20 Botulinum neurotoxin applications in ophthalmology
- Chapter 21 Cosmetic uses of botulinum neurotoxins
- Chapter 22 Hyperhidrosis
- Chapter 23 Botulinum neurotoxin A treatment for ischemic digits
- Chapter 24 Botulinum neurotoxin in wound healing
- Chapter 25 Use of botulinum neurotoxin in neuropathic pain
- Chapter 26 The use of botulinum neurotoxin in the management of headache disorders
- Chapter 27 The use of botulinum neurotoxin in musculoskeletal pain and arthritis
- Chapter 28 Treatment of plantar fasciitis with botulinum neurotoxins
- Chapter 29 Use of botulinum neurotoxin in the treatment of low-back pain
- Chapter 30 Use of botulinum neurotoxin in the treatment of piriformis syndrome
- Chapter 31 Ultrasound-guided botulinum neurotoxin injections for thoracic outlet syndrome
- Chapter 32 Botulinum neurotoxin in the gastrointestinal tract
- Chapter 33 Botulinum neurotoxin applications in urological disorders
- Index
- References
Chapter 8 - Treatment of blepharospasm
Published online by Cambridge University Press: 05 February 2014
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Chapter 1 The pretherapeutic history of botulinum neurotoxin
- Chapter 2 Botulinum neurotoxin: history of clinical development
- Chapter 3 Pharmacology of botulinum neurotoxins
- Chapter 4 Immunological properties of botulinum neurotoxins
- Chapter 5 Treatment of cervical dystonia
- Chapter 6 Examination and treatment of complex cervical dystonia
- Chapter 7 Ultrasound guidance for botulinum neurotoxin therapy: cervical dystonia
- Chapter 8 Treatment of blepharospasm
- Chapter 9 Botulinum neurotoxin in oromandibular dystonia
- Chapter 10 Treatment of focal hand dystonia
- Chapter 11 Botulinum neurotoxin therapy of laryngeal muscle hyperactivity syndromes
- Chapter 12 The use of botulinum neurotoxin in otorhinolaryngology
- Chapter 13 Treatment of hemifacial spasm
- Chapter 14 Spasticity
- Chapter 15 The use of botulinum neurotoxin in spastic infantile cerebral palsy
- Chapter 16 The role of ultrasound for botulinum neurotoxin injection in childhood spasticity
- Chapter 17 The use of botulinum neurotoxin in spasticity using ultrasound guidance
- Chapter 18 The use of botulinum neurotoxin in tic disorders and essential hand and head tremor
- Chapter 19 Treatment of stiff-person syndrome with botulinum neurotoxin
- Chapter 20 Botulinum neurotoxin applications in ophthalmology
- Chapter 21 Cosmetic uses of botulinum neurotoxins
- Chapter 22 Hyperhidrosis
- Chapter 23 Botulinum neurotoxin A treatment for ischemic digits
- Chapter 24 Botulinum neurotoxin in wound healing
- Chapter 25 Use of botulinum neurotoxin in neuropathic pain
- Chapter 26 The use of botulinum neurotoxin in the management of headache disorders
- Chapter 27 The use of botulinum neurotoxin in musculoskeletal pain and arthritis
- Chapter 28 Treatment of plantar fasciitis with botulinum neurotoxins
- Chapter 29 Use of botulinum neurotoxin in the treatment of low-back pain
- Chapter 30 Use of botulinum neurotoxin in the treatment of piriformis syndrome
- Chapter 31 Ultrasound-guided botulinum neurotoxin injections for thoracic outlet syndrome
- Chapter 32 Botulinum neurotoxin in the gastrointestinal tract
- Chapter 33 Botulinum neurotoxin applications in urological disorders
- Index
- References
Summary
Introduction
Primary blepharospasm is a common adult-onset focal dystonia, characterized by involuntary contractions of the periocular muscles that result in forceful eye closure and impaired opening and closing of the eyes (Marsden, 1976; Berardelli et al., 1985; Defazio et al., 2007). The severity of blepharospasm can vary from repeated frequent blinking, causing only minor discomfort, to persistent forceful closure of the eyelids leading to functional blindness (Fig. 8.1). Blepharospasm can be caused by tonic or phasic contractions of the orbicularis oculi muscles and may also be associated with levator palpebrae muscle inhibition (apraxia of eyelid opening) or involuntary movements in the lower face and masticatory muscles (Meige’s syndrome). In most cases, blepharospasm is considered primary and is only occasionally secondary to structural brain lesions or drug therapy (Jankovic, 2006).
Pathophysiology
Neurophysiological recordings of the blink reflex have given important insights into the pathophysiology of blepharospasm. In patients with blepharospasm, the recovery cycle of the R2 component of the blink reflex is enhanced, presumably owing to a lack of brainstem interneuronal inhibition (Berardelli et al., 1985, 1998). Blepharospasm is also associated with an abnormal responsiveness of the blink reflex to sensory stimuli. Studies using magnetic brain stimulation also suggest a loss of inhibition and increased plasticity in the central nervous system of patients with blepharospasm (Defazio et al., 2007; Quartarone et al., 2008).
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- Manual of Botulinum Toxin Therapy , pp. 60 - 63Publisher: Cambridge University PressPrint publication year: 2014