The Effect of Bangerter Occlusion Foils on Blepharospasm and Hemifacial Spasm in Occlusion-Positive and Occlusion-Negative Patients

Abstract

Objective:To test the hypothesis that occlusion-positive (OP) patients with blepharospasm (BEB) or hemifacial spasm (HFS) will benefit from a Bangerter occlusion foil (BOF), compared to occlusion-negative (ON) patients. OP/ON was based on immediate improvement in spasm with placement of a hand in front of either eye.Design:Prospective non-randomised single-centre pilot study.Participants:Fifteen-patients (6 BEB, 9 HFS).Methods:Patients were identified as OP or ON and wore highest-density BOF tolerable over one spectacle lens for 1 month. Outcomes were assessed at 1 month.Main Outcome Measures:Validated quality-of-life questionnaire (CDQ-24), scores of blink-rate and spasm severity assessed by two observers from video-recordings.Results:OP group had mean improvement in all scores. There was no change or worsening of scores in the ON group. In both BEB and HFS, more OP patients reported subjective benefit from wearing a foil (2 of 4 BEB, and 2 of 2 HFS) compared to the ON group (0 of 2 BEB, and 1 of 7 HFS).Conclusion:OP patients with BEB and HFS are more likely to experience improvement in spasms from wearing a BOF compared to ON patients. The occlusion test should be considered on all patients with BEB or HFS.

Effectiveness and cost-effectiveness of a patient-initiated botulinum toxin treatment model for blepharospasm and hemifacial spasm compared to standard care: study protocol for a randomised controlled trial

“…Quality of life will be measured using the Craniocervical Dystonia Questionnaire (CDQ-24; [ 19 ]), which was developed and validated in patients with blepharospasm and has also been used with success in patients with hemifacial spasm [ 20 ]. This 24-item measure assesses quality of life across five domains: stigma, emotional well-being, pain, activities of daily living and social/family life.…”

“…In order to obtain comparable scores for the individual subscales, raw sub-scores (= sum of the individual item score) are linearly transformed to a 0–100 scale, where a score of 0 indicates the best and a score of 100 the worst possible quality of life. The measure has been found to possess good internal consistency with Cronbach’s alphas ranging from 0.77 to 0.89, good construct validity when compared who the Short Form 36 (SF-36), good discriminant validity and test-retest reliability [ 20 ].…”