Blepharospasm with elevated anti-acetylcholine receptor antibody titer

Introduction: Hemifacial spasm represents a segmental myoclonus of muscles innervated by the facial nerve, which is usually and successfully treated with botulinum toxin. Botulinum toxin (BTX) acts as acetylcholine release inhibitor at presynaptic cholinergic junctions and therefore is considered contraindicated (or administrable with caution) in patients with neuromuscular disorders like myasthenia gravis (MG). Moreover, to date the association of hemifacial spasm and ocular MG is extremely rare and only few cases have been described. Case Presentation: We report the case of a 73 years old man with a 3-year history of ocular MG who developed a left hemifacial spasm. The patient underwent for hemispasm, treatment with BTX type A (abobotulinum toxin-A, total dose of 50 IU) that resulted safe and successful at 6 months re-evaluation. Conclusion: Our results suggest that in selected cases with concomitant MG and conditions characterized by orbicularis oculi spasms or hemispasm, BTX therapy may not be contraindicated and could be given at longer intervals due to prolonged effects.

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AChR+ Ocular Myasthenia and Facial Hemispasm: A Case Report of Unusual Association and Botulinum Toxic Type A Safety and Efficacy

Zoccolella

Gigante

Misceo

2023

CDS

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Ocular myasthenia gravis and blepharospasm: similarities and differences

Zalyalova,

Khafizova,

Popova

2023

РНЖ

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The ocular myasthenia gravis and blepharospasm are two diseases that can involve the periocular area in the pathological process. In both diseases, patients complain of closing their eyes. In both cases may be observed frequent blinking, worsening of symptoms in bright light. Blepharospasm associated with a violent contraction of the circular muscle of the eye, and myasthenia gravis related pathology of the neuromuscular synapse of the extraocular muscles. The article presents the clinical features of both diseases and diagnostic maneuvers that help in determining the diagnosis of the ocular myasthenia gravis and blepharospasm in clinically difficult cases.

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Blepharospasm with elevated anti-acetylcholine receptor antibody titer

Abstract: Patients with BSP had an elevated anti-AChR Abs titer, which suggests that dysimmunity plays a role in the onset of BSP. An increased anti-AChR Abs titer may be a predictor for poor response to BoNT-A in BSP.

Cited by 2 publications

References 21 publications

AChR+ Ocular Myasthenia and Facial Hemispasm: A Case Report of Unusual Association and Botulinum Toxic Type A Safety and Efficacy

AChR+ Ocular Myasthenia and Facial Hemispasm: A Case Report of Unusual Association and Botulinum Toxic Type A Safety and Efficacy

Ocular myasthenia gravis and blepharospasm: similarities and differences

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