Blepharospasm and hemifacial spasm: a protocol for titration of botulinum toxin dose to the individual patient and for the management of refractory cases

Eye
E OrtisiJ R O Collin

Abstract

To evaluate a protocol for the treatment of facial dystonias. A retrospective noncomparative interventional case series of all patients who attended a specialised tertiary referral clinic between January 2000 and January 2003. At the start of treatment, patients were seen and treated at weekly intervals until their symptoms were controlled or they developed complications. The sum of the weekly doses was taken as the individual patient dose and then given at 3-4 monthly intervals as required for the individual patient. Refractory cases of spasm underwent orbicularis muscle reduction. Pretarsal spasm was treated with pretarsal botulinum toxin. If the spasm was relieved but the patient could not open their eyelids, a trial of ptosis props was undertaken and the toxin injections continued, before considering a brow suspension. If patients could not see because of a spastic Bell's phenomenon, they were given centrally acting systemic medication. Of 182 new patients, 63 (35%) required two or more sets of injections to titrate their optimum dose of toxin. Symptoms improved in 169 patients (93%). Of a total 332 new patients and follow-up patients, 47 (14%) underwent surgery during their management, 36 protractor myectomy, and 13 brow s...Continue Reading

References

Aug 1, 1991·The British Journal of Ophthalmology·A K BatesA C Bird
Jun 1, 1988·Journal of Neurology, Neurosurgery, and Psychiatry·F GrandasC D Marsden
Sep 1, 1987·The British Journal of Ophthalmology·J S Elston
Mar 1, 1985·Archives of Ophthalmology·A B ScottH A Stubbs
Oct 1, 1985·Mayo Clinic Proceedings·T W JonesJ R Samples
Jun 1, 1981·Archives of Ophthalmology·W N Gillum, R L Anderson
Sep 1, 1995·Journal of Neurology, Neurosurgery, and Psychiatry·M AramidehJ D Speelman
Nov 1, 1994·Movement Disorders : Official Journal of the Movement Disorder Society·P Krack, M H Marion
Dec 1, 1993·Ophthalmology·R M SiatkowskiW J Feuer
Aug 1, 1997·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·P Roggenkämper, Z Nüssgens
Oct 23, 1998·Ophthalmic Plastic and Reconstructive Surgery·R L AndersonD R Jordan
Jan 12, 2001·Acta Neurologica Scandinavica·O TuchaK W Lange
Jan 17, 2002·Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie·G T Drummond, B J Hinz
Jul 26, 2002·Journal of Neurology·J MüllerUNKNOWN Austrian Botulinum Toxin and Dystonia Study Group
Sep 21, 2002·Journal of Neurology·Thomas Müller, Jens Reimer
Aug 16, 2003·Ophthalmic Plastic and Reconstructive Surgery·Elizabeth A BradleyGeorge B Bartley

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Citations

Apr 30, 2014·Ophthalmic Plastic and Reconstructive Surgery·Lily HuangJulian D Perry
Aug 19, 2007·Current Opinion in Ophthalmology·Altug Cetinkaya, Paul A Brannan
Jun 24, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mine Hayriye SorgunMuhittin Cenk Akbostanci
Jan 27, 2009·Journal of Child Neurology·Samah Khalil AburahmaZouhair Amarin
Sep 6, 2014·Ophthalmic Plastic and Reconstructive Surgery·Tiffany L KentJohn B Holds
Aug 19, 2007·Current Opinion in Ophthalmology

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