Videonystagmography as a tool to assess blepharospasm before and after botulinum toxin injection

Casse, G.; Adenis, J.‐P.; Sauvage, Jean‐Pierre; Robert, Pierre-Yves

doi:10.1007/s00417-008-0877-5

Cited by 5 publications

(4 citation statements)

References 26 publications

(33 reference statements)

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“…The development of alternate devices for the measurement of blepharospasm could alleviate the subjectivity issue. Of note, several studies have evaluated the use of video nystagmography as a measurement tool for blinking in blepharospasm before and after botulinum toxin treatment (Casse et al 2008, 2009). The objectivity of this method is advantageous, although further studies are needed to assess its validity.…”

Section: Considerations/conclusionmentioning

confidence: 99%

Difficulties with differentiating botulinum toxin treatment effects in essential blepharospasm

2011

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Blepharospasm is a focal dystonia in which the extraocular muscles contract repetitively, leading to excessive blinking and forced eyelid closure. Botulinum toxin type A (BoNTA) is the primary symptomatic treatment for blepharospasm and its effects have been evaluated using numerous rating scales. The main scales in use today were initially used to determine whether BoNTA treatment was superior to placebo, and most controlled trials have confirmed this. More recently, these scales have been used to determine whether there are efficacy differences between different BoNTs in blepharospasm. However, although the scales used in these trials are able to differentiate the effects of BoNT from placebo, they may not be sensitive enough to differentiate between BoNTs. Most of the scales include only four possible points for each item, which would necessitate a 25% greater improvement in one group than the other to detect any differences. Current scales are also relatively insensitive to patients with mild disability who may experience mainly psychosocial problems related to their blepharospasm. Clinical trials comparing BoNTs that include substantial numbers of mildly affected patients may be unlikely to find differences because the scales do not adequately measure mild symptoms. Additional challenges with evaluating blepharospasm include the lack of precision and objectivity of current measures, symptom variability, the need to evaluate aspects of the disorder that are most important to patients, and the different types of blepharospasm. Although no single scale may be able to capture all relevant aspects of blepharospasm, more sensitive and patient-centered scales are needed.

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Section: Considerations/conclusionmentioning

confidence: 99%

Difficulties with differentiating botulinum toxin treatment effects in essential blepharospasm

2011

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“…Eyelid spasms in EB exhibit chaotic patterns of abnormal eyelid movements, making it challenging to assess this condition objectively and accurately [3]. Previously employed objective approaches were based on more invasive (e.g., electromyography), less accurate systems including reviewing videotapes, or more complex methods [4][5][6][7]. Our group had previously designed an objective tool using small blue light-emitting diodes that were placed on the pretarsal region of both the upper lids and were connected to an electronic circuit and a high-speed camera to assess eyelid spasms based on the energy generated by the upper lid.…”

Section: Introductionmentioning

confidence: 99%

Smartphone and custom‐made software to assess the effect of botulinum toxin in essential blepharospasm: Initial results

Yabumoto

Osaki

Gameiro

et al. 2023

Euro J of Neurology

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Background and purpose: It is challenging to assess essential blepharospasm (EB) patients objectively because they exhibit chaotic patterns of abnormal eyelid movements.Previously employed objective approaches used systems with low levels of accuracy systems or were too complex to be applied in routine clinical practice. We aimed to develop a practical tool using a smartphone camera and custom-made software to objectively assess the therapeutic effects of botulinum toxin in blepharospasm patients.Methods: Thirty-four patients with EB were evaluated before and 15 days after receiving onabotulinumtoxinA injections. The control group was composed of 19 age-matched healthy individuals. A smartphone (iPhone 6 S; Apple) was used to record spontaneous eyelid movements for 3 min, after which eyelid movement frequency was analysed using custom-made software.Results: Before treatment, eyelid movement frequency was significantly higher in the EB group (21.55 ± 13.30 movements/min) compared to the control group (8.26 ± 8.89 eyelid movements/min; p < 0.001). The frequency of spontaneous eyelid movements was significantly reduced after treatment in the EB patients (8.46 ± 6.32 eyelid movements/min; p < 0.001). After treatment, no statistically significant difference in eyelid movement rate was observed between the EB patients and the control group (p = 0.32).Conclusions: Assessment of the spontaneous eyelid movements obtained with the smartphone camera and analysed with the custom-made software enabled us to objectively measure the therapeutic effects of botulinum toxin in patients with blepharospasm. Further refinement of this system could enable customized and fine adjustments to botulinum toxin doses based on each patient's needs.

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“…This is currently the most widely used clinical scale, although it is a subjective and qualitative evaluation. Video recording systems have been incorporated to measure the blinking frequency and eyelid closure time to evaluate the efficacy of botulinum toxin treatment 12 – 14 . Osaki et al estimated the upper eyelid energy power using a high-speed camera and micro light-emitting diodes 15 , 16 .…”

Section: Introductionmentioning

confidence: 99%

Quantitative evaluation of blinking in blepharospasm using electrooculogram-integrated smart eyeglasses

Yoshimura

Hosotani

Kimura

et al. 2023

Sci Rep

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Smart eyeglasses with an integrated electrooculogram (EOG) device (JINS MEME ES_R®, JINS Inc.) were evaluated as a quantitative diagnostic tool for blepharospasm. Participants without blepharospasm (n = 21) and patients with blepharospasm (n = 19) undertook two voluntary blinking tests (light and fast) while wearing the smart eyeglasses. Vertical (Vv) and horizontal (Vh) components were extracted from time-series voltage waveforms recorded during 30 s of the blinking tests. Two parameters, the ratio between the maximum and minimum values in the power spectrum (peak-bottom ratio, Fourier transform analysis) and the mean amplitude of the EOG waveform (peak amplitude analysis) were calculated. The mean amplitude of Vh from light and fast blinking was significantly higher in the blepharospasm group than in the control group (P < 0.05 and P < 0.05). Similarly, the peak-bottom ratio of Vv from light and fast blinking was significantly lower in the blepharospasm group than in the control group (P < 0.05 and P < 0.05). The mean amplitude of Vh and peak-bottom ratio of Vv correlated with the scores determined using the Jankovic rating scale (P < 0.05 and P < 0.01). Therefore, these parameters are sufficiently accurate for objective blepharospasm classification and diagnosis.

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Videonystagmography as a tool to assess blepharospasm before and after botulinum toxin injection

Abstract: PO can be used as the indirect sign of blinking. Videonystagmography provides a real-time result, and could be used to objectively evaluate the effect of botulinum toxin treatment in essential blepharospasm patients.

Cited by 5 publications

References 26 publications

Difficulties with differentiating botulinum toxin treatment effects in essential blepharospasm

Difficulties with differentiating botulinum toxin treatment effects in essential blepharospasm

Smartphone and custom‐made software to assess the effect of botulinum toxin in essential blepharospasm: Initial results

Quantitative evaluation of blinking in blepharospasm using electrooculogram-integrated smart eyeglasses

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