Patients with essential blepharospasm and glaucoma: case reports

Nicoletti, André Gustavo Bombana; Zacharias, Leandro Cabral; Susanna, Remo; Matayoshi, Suzana

doi:10.1590/s0004-27492008000500028

Cited by 8 publications

(10 citation statements)

References 10 publications

(12 reference statements)

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“…The result of this study showed that there was no change in the IOP before or after Botox injection; in fact, the IOP remained normal on all occasions. This is in contrast to the study done by Nicoletti (2008) where they proposed that IOP may rise in blepharospasm patients because of the eyelid closure, present with repetitive and spasmodic eyelid contractions, could be an additional risk factor for glaucomatous damage.…”

Section: Discussioncontrasting

confidence: 71%

Outcome of Injection Botulinum Toxin in Blepharospasm

Amatya

Limbu²,

Sthapit³

et al. 2021

Nep J Oph

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Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods: It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared. Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site. Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

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Section: Discussioncontrasting

confidence: 71%

Outcome of Injection Botulinum Toxin in Blepharospasm

Amatya

Limbu²,

Sthapit³

et al. 2021

Nep J Oph

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“…There is a paucity of research examining the relationship between blepharospasm and glaucoma, without conclusive evidence linking the two. 11,12 Similarly, there is a lack of research investigating the effects of belpharospasm on automated perimetry. In addition to central nervous system etiologies, psychological and environmental stressors during perimetry testing, including desiccation of an already compromised ocular surface, may also lead to blepharospasm and fallacious defects on automated perimetry.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is growing concern over the emergence of vancomycin-resistant S. aureus. 5,11 Given the increase in community-acquired MRSA, 12 endophthalmitis caused by this pathogen may become a more frequent presentation.In conclusion, MRSA endogenous endophthalmitis is a severe, vision-threatening ocular condition. This case illustrates how a seemingly benign presentation can be an indication of a serious illness.…”

mentioning

confidence: 99%

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Blepharospasm as a masquerade of glaucomatous visual field defects

Dikopf

Setabutr

Vajaranant

2017

Canadian Journal of Ophthalmology

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Phlegmon is an infection of soft tissue and often involves connective tissue. It is characterized by diffuse inflammation, with formation of suppurative exudate, typically at sites of injury or foreign body, and a predisposition in patients with immunosuppression. Radiologic studies revealing soft tissue gas are suggestive, although definitive diagnosis is established through tissue cultures. Patients are treated with systemic antimicrobials, and surgical intervention may be indicated when lesions are rapidly progressive or refractory to medical management. 10 The prognosis for the visual outcomes of endogenous endophthalmitis is guarded. A review of the literature since 1986 reveals that 69% of patients experience blindness and that 25% require enucleation or evisceration; only 5% had a final visual acuity of 20/20. 2 Given the likelihood of poor visual outcomes, our case illustrates the importance of urgent empiric treatment with systemic and intraocular broad-spectrum antimicrobials. We used intraocular and systemic vancomycin to treat the MRSA infection. However, there is growing concern over the emergence of vancomycin-resistant S. aureus. 5,11 Given the increase in community-acquired MRSA, 12 endophthalmitis caused by this pathogen may become a more frequent presentation.In conclusion, MRSA endogenous endophthalmitis is a severe, vision-threatening ocular condition. This case illustrates how a seemingly benign presentation can be an indication of a serious illness. When evaluating patients with presumed endogenous endophthalmitis, it is important to include MRSA in the differential diagnosis and consider soft tissue infection as a possible infectious source. Prompt and aggressive treatment with intraocular and systemic antibiotics is imperative to prevent potential vision loss.

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“…From these fi ndings, it was hypothesized that frequent forced eyelid closures occurring in blepharospasm may produce episodic rises in intraocular pressure. Larger studies are warranted to explore this relationship, as fi ndings may support more frequent eye examination screenings for glaucoma [23]. One large case-control study from Italy assessed two exposures known to infl uence the risk of Parkinson's disease: cigarette smoking and coffee drinking; the investigators found an inverse relationship between coffee drinking (including a dose effect) and blepharospasm [24].…”

Section: Late-onset Primary Torsion Dystoniamentioning

confidence: 99%

What’s new in dystonia?

Shanker

Bressman²

2009

Curr Neurol Neurosci Rep

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Several advances have been made in dystonia in both the basic science and clinical realms. Recent research has implicated dysfunctional circuitry outside of the basal ganglia, thereby broadening our understanding of the pathophysiology of dystonia. Genetic achievements include the discovery of a genetic modifier that protects against clinical expression in DYT1 and the identification of the DYT6 gene (THAP1). Several reports provided expanded descriptions of the clinical features of dystonia and its associated symptoms. Follow-up studies of deep brain stimulation, typically targeting the globus pallidus internus, have been largely positive. The success of deep brain stimulation in many cases of generalized dystonia has led to trials in other forms of dystonia, such as medically refractive cervical dystonia. This article reviews relevant recent findings in dystonia.

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Patients with essential blepharospasm and glaucoma: case reports

Cited by 8 publications

References 10 publications

Outcome of Injection Botulinum Toxin in Blepharospasm

Outcome of Injection Botulinum Toxin in Blepharospasm

Blepharospasm as a masquerade of glaucomatous visual field defects

What’s new in dystonia?

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