Blepharospasm Surgery

Blepharospasm with Anterocollis: A Distinctive Subphenotype of Segmental Craniocervical Dystonia

“…has been associated with mild improvement in neck discomfort. This patient did not obtain satisfactory clinical improvement with injections of onabotulinumtoxin A and underwent limited OO myectomy at age 50 and, more extensive, integrated upper eyelid myectomy25 at age 56. Bilateral electromyographically (EMG)-guided injections of onabotulinumtoxin A (178–255 units) into the sternocleidomastoid, scalene, levator scapulae, longus colli, and longus capitis muscles were performed on three occasions, but provided only minimal benefit.…”

“…Injections of onabotulinumtoxin A were moderately beneficial for blepharospasm, but produced minimal improvement in cervical dystonia. Additional reductions in blepharospasm severity and improved responses to injections of onabotulinumtoxin A were apparent after extensive integrated OO myectomy 25. However, owing to progression of anterocollis and persistent need for onabotulinumtoxin A injections to control blepharospasm, the subject underwent bilateral microelectrode-guided placement of bilateral globus pallidus pars interna (GPi) electrodes (Medtronic Kinetra).…”

“…Subsequently, an integrated upper eyelid myectomy25 was required to control blepharospasm and AEO. Since the more extensive myectomy, blepharospasm and AEO have responded well to injections (onabotulinumtoxin A: 10 units each upper eyelid pretarsal OO muscle, 62 units total).…”

“…Sensory tricks for cervical dystonia (touching the side or back of the neck or chin) and blepharospasm (touching a lateral eyebrow) provide limited relief. He first underwent limited OO myectomy, which was followed by an integrated upper eyelid myectomy,25 and then by lower eyelid myectomy. More recently, he underwent OO myo-osseous fixation with titanium screws,26 which has been associated with marked subjective improvement in blepharospasm (∼90%).…”

Blepharospasm with Anterocollis: A Distinctive Subphenotype of Segmental Craniocervical Dystonia

“…has been associated with mild improvement in neck discomfort. This patient did not obtain satisfactory clinical improvement with injections of onabotulinumtoxin A and underwent limited OO myectomy at age 50 and, more extensive, integrated upper eyelid myectomy25 at age 56. Bilateral electromyographically (EMG)-guided injections of onabotulinumtoxin A (178–255 units) into the sternocleidomastoid, scalene, levator scapulae, longus colli, and longus capitis muscles were performed on three occasions, but provided only minimal benefit.…”

“…Injections of onabotulinumtoxin A were moderately beneficial for blepharospasm, but produced minimal improvement in cervical dystonia. Additional reductions in blepharospasm severity and improved responses to injections of onabotulinumtoxin A were apparent after extensive integrated OO myectomy 25. However, owing to progression of anterocollis and persistent need for onabotulinumtoxin A injections to control blepharospasm, the subject underwent bilateral microelectrode-guided placement of bilateral globus pallidus pars interna (GPi) electrodes (Medtronic Kinetra).…”

“…Subsequently, an integrated upper eyelid myectomy25 was required to control blepharospasm and AEO. Since the more extensive myectomy, blepharospasm and AEO have responded well to injections (onabotulinumtoxin A: 10 units each upper eyelid pretarsal OO muscle, 62 units total).…”

“…Sensory tricks for cervical dystonia (touching the side or back of the neck or chin) and blepharospasm (touching a lateral eyebrow) provide limited relief. He first underwent limited OO myectomy, which was followed by an integrated upper eyelid myectomy,25 and then by lower eyelid myectomy. More recently, he underwent OO myo-osseous fixation with titanium screws,26 which has been associated with marked subjective improvement in blepharospasm (∼90%).…”

Levator aponeurosis advancement with partial orbicularis oculi muscle resection for the treatment of Marin Amat syndrome with aponeurotic ptosis: two Case reports

“…Additionally, Gillum et al. [ 16 ] reported there were no cases of long-term lagophthalmos occurring due to the difficulty of complete removal of the OOM, however, the recurrences of blepharospasm were observed in some patients.…”

Blepharospasm with Anterocollis: A Distinctive Subphenotype of Segmental Craniocervical Dystonia

“…has been associated with mild improvement in neck discomfort. This patient did not obtain satisfactory clinical improvement with injections of onabotulinumtoxin A and underwent limited OO myectomy at age 50 and, more extensive, integrated upper eyelid myectomy25 at age 56. Bilateral electromyographically (EMG)-guided injections of onabotulinumtoxin A (178–255 units) into the sternocleidomastoid, scalene, levator scapulae, longus colli, and longus capitis muscles were performed on three occasions, but provided only minimal benefit.…”

“…Injections of onabotulinumtoxin A were moderately beneficial for blepharospasm, but produced minimal improvement in cervical dystonia. Additional reductions in blepharospasm severity and improved responses to injections of onabotulinumtoxin A were apparent after extensive integrated OO myectomy 25. However, owing to progression of anterocollis and persistent need for onabotulinumtoxin A injections to control blepharospasm, the subject underwent bilateral microelectrode-guided placement of bilateral globus pallidus pars interna (GPi) electrodes (Medtronic Kinetra).…”

“…Subsequently, an integrated upper eyelid myectomy25 was required to control blepharospasm and AEO. Since the more extensive myectomy, blepharospasm and AEO have responded well to injections (onabotulinumtoxin A: 10 units each upper eyelid pretarsal OO muscle, 62 units total).…”

“…Sensory tricks for cervical dystonia (touching the side or back of the neck or chin) and blepharospasm (touching a lateral eyebrow) provide limited relief. He first underwent limited OO myectomy, which was followed by an integrated upper eyelid myectomy,25 and then by lower eyelid myectomy. More recently, he underwent OO myo-osseous fixation with titanium screws,26 which has been associated with marked subjective improvement in blepharospasm (∼90%).…”

Levator aponeurosis advancement with partial orbicularis oculi muscle resection for the treatment of Marin Amat syndrome with aponeurotic ptosis: two Case reports

“…Additionally, Gillum et al. [ 16 ] reported there were no cases of long-term lagophthalmos occurring due to the difficulty of complete removal of the OOM, however, the recurrences of blepharospasm were observed in some patients.…”

Blepharospasm with Anterocollis: A Distinctive Subphenotype of Segmental Craniocervical Dystonia

“…has been associated with mild improvement in neck discomfort. This patient did not obtain satisfactory clinical improvement with injections of onabotulinumtoxin A and underwent limited OO myectomy at age 50 and, more extensive, integrated upper eyelid myectomy25 at age 56. Bilateral electromyographically (EMG)-guided injections of onabotulinumtoxin A (178–255 units) into the sternocleidomastoid, scalene, levator scapulae, longus colli, and longus capitis muscles were performed on three occasions, but provided only minimal benefit.…”

“…Injections of onabotulinumtoxin A were moderately beneficial for blepharospasm, but produced minimal improvement in cervical dystonia. Additional reductions in blepharospasm severity and improved responses to injections of onabotulinumtoxin A were apparent after extensive integrated OO myectomy 25. However, owing to progression of anterocollis and persistent need for onabotulinumtoxin A injections to control blepharospasm, the subject underwent bilateral microelectrode-guided placement of bilateral globus pallidus pars interna (GPi) electrodes (Medtronic Kinetra).…”

“…Subsequently, an integrated upper eyelid myectomy25 was required to control blepharospasm and AEO. Since the more extensive myectomy, blepharospasm and AEO have responded well to injections (onabotulinumtoxin A: 10 units each upper eyelid pretarsal OO muscle, 62 units total).…”

“…Sensory tricks for cervical dystonia (touching the side or back of the neck or chin) and blepharospasm (touching a lateral eyebrow) provide limited relief. He first underwent limited OO myectomy, which was followed by an integrated upper eyelid myectomy,25 and then by lower eyelid myectomy. More recently, he underwent OO myo-osseous fixation with titanium screws,26 which has been associated with marked subjective improvement in blepharospasm (∼90%).…”

Levator aponeurosis advancement with partial orbicularis oculi muscle resection for the treatment of Marin Amat syndrome with aponeurotic ptosis: two Case reports

“…Additionally, Gillum et al. [ 16 ] reported there were no cases of long-term lagophthalmos occurring due to the difficulty of complete removal of the OOM, however, the recurrences of blepharospasm were observed in some patients.…”