Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1987 Sep;71(9):664–668. doi: 10.1136/bjo.71.9.664

Long-term results of treatment of idiopathic blepharospasm with botulinum toxin injections.

J S Elston 1
PMCID: PMC1041270  PMID: 3663559

Abstract

One hundred and one patients with idiopathic blepharospasm have been treated with injections of botulinum toxin A into the orbicularis oculi. Ten had previously had facial nerve avulsions and responded well, normal visual function being restored in the majority (7/10) for an average of 14 weeks. Without prior surgical treatment the response was more variable, but 71/91 regained normal or near normal vision. Older patients, those with a family history of the condition, and those without oromandibular dystonia responded slightly better. The severity of the blepharospasm, the length of the history, and spontaneous resolution of an episode of focal dystonia in the past had no influence on the outcome. Results were poor in the presence of an associated neurological disorder. Side effects, particularly a temporary partial ptosis, were common but were well tolerated. The average duration of improvement was eight weeks in men, nine in women, and there was no evidence of any increase in duration after multiple injections. Eighty nine patients continued with injections, 11 opted for surgical treatment, and one resumed drugs.

Full text

PDF
668

Images in this article

664Image
on p.664
665Image
on p.665
667Image
on p.667

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Biglan A. W., Gonnering R., Lockhart L. B., Rabin B., Fuerste F. H. Absence of antibody production in patients treated with botulinum A toxin. Am J Ophthalmol. 1986 Feb 15;101(2):232–235. doi: 10.1016/0002-9394(86)90601-x. [DOI] [PubMed] [Google Scholar]
  2. Bird A. C., McDonald W. I. Essential blepharospasm. Trans Ophthalmol Soc U K. 1975 Jul;95(2):250–253. [PubMed] [Google Scholar]
  3. Boroff D. A., del Castillo J., Evoy W. H., Steinhardt R. A. Observations on the action of type A botulinum toxin on frog neuromuscular junctions. J Physiol. 1974 Jul;240(2):227–253. doi: 10.1113/jphysiol.1974.sp010608. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Duchen L. W. An electron microscopic study of the changes induced by botulinum toxin in the motor end-plates of slow and fast skeletal muscle fibres of the mouse. J Neurol Sci. 1971 Sep;14(1):47–60. doi: 10.1016/0022-510x(71)90129-8. [DOI] [PubMed] [Google Scholar]
  5. Duchen L. W. Changes in the electron microscopic structure of slow and fast skeletal muscle fibres of the mouse after the local injection of botulinum toxin. J Neurol Sci. 1971 Sep;14(1):61–74. doi: 10.1016/0022-510x(71)90130-4. [DOI] [PubMed] [Google Scholar]
  6. Elston J. S., Russell R. W. Effect of treatment with botulinum toxin on neurogenic blepharospasm. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1857–1859. doi: 10.1136/bmj.290.6485.1857. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Frueh B. R., Felt D. P., Wojno T. H., Musch D. C. Treatment of blepharospasm with botulinum toxin. A preliminary report. Arch Ophthalmol. 1984 Oct;102(10):1464–1468. doi: 10.1001/archopht.1984.01040031184014. [DOI] [PubMed] [Google Scholar]
  8. Gillum W. N., Anderson R. L. Blepharospasm surgery. An anatomical approach. Arch Ophthalmol. 1981 Jun;99(6):1056–1062. doi: 10.1001/archopht.1981.03930011056015. [DOI] [PubMed] [Google Scholar]
  9. Jankovic J., Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients. Ann Neurol. 1983 Apr;13(4):402–411. doi: 10.1002/ana.410130406. [DOI] [PubMed] [Google Scholar]
  10. Scott A. B. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. Ophthalmology. 1980 Oct;87(10):1044–1049. doi: 10.1016/s0161-6420(80)35127-0. [DOI] [PubMed] [Google Scholar]
  11. Scott A. B., Kennedy R. A., Stubbs H. A. Botulinum A toxin injection as a treatment for blepharospasm. Arch Ophthalmol. 1985 Mar;103(3):347–350. doi: 10.1001/archopht.1985.01050030043017. [DOI] [PubMed] [Google Scholar]
  12. Scott A. B., Rosenbaum A., Collins C. C. Pharmacologic weakening of extraocular muscles. Invest Ophthalmol. 1973 Dec;12(12):924–927. [PubMed] [Google Scholar]
  13. Skarf B., Sharpe J. A. Choline for blepharospasm. N Engl J Med. 1981 Oct 15;305(16):957–958. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES