Blepharospasm: past, present, and future.

Abstract	To investigate causes, associations, and results of treatment with blepharospasm, 1,653 patients were evaluated by extensive questionnaires to study blepharospasm and long-term results of treatment with the full myectomy operation, botulinum-A toxin, drug therapy, and help from the Benign Essential Blepharospasm Research Foundation (BEBRF). The percent of patients improved by the BEBRF was 90%, full myectomy 88%, botulinum-A toxin 86%, and drug therapy 43%. The patient acceptance rate for the BEBRF was 96%, full myectomy 82%, botulinum-A toxin 95%, and drug therapy 57%. Blepharospasm is multifactorial in origin and manifestation. A vicious cycle and defective circuit theory to explain in origin and direct treatment rather than a defective specific locus is presented. All four forms of therapy evaluated are useful and must be tailored to the patient's needs. Mattie Lou Koster and the BEBRF have helped blepharospasm sufferers more than any other modality, and all patients should be informed of this support group. The full myectomy is reserved for botulinum-A toxin failures, and the limited myectomy is an excellent adjunct to botulinum-A toxin.
Authors	R L Anderson, B C Patel, J B Holds, D R Jordan
Journal	Ophthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) Vol. 14 Issue 5 Pg. 305-17 (Sep 1998) ISSN: 0740-9303 [Print] United States
PMID	9783280 (Publication Type: Historical Article, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References	Cholinergic Antagonists GABA Antagonists Botulinum Toxins, Type A
Topics	Blepharospasm (etiology, history, therapy) Botulinum Toxins, Type A (therapeutic use) Cholinergic Antagonists (therapeutic use) Eyelids (innervation, surgery) Facial Muscles (pathology) Female Forecasting GABA Antagonists (therapeutic use) History, 19th Century History, 20th Century Humans Male Muscle Denervation Oculomotor Muscles (innervation, surgery) Retrospective Studies Spasm (etiology, history, therapy) Surveys and Questionnaires

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