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By Ed Susman, Contributing Writer, MedPage Today Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse PlannerNote that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.Patients with blepharospasm, an involuntary closure of the eyelid caused by spasms of the ocular muscles, can get relief with injections of botulinum toxin.Note that blepharospasm secondary to Parkinson's disease appeared to achieve greater relief with botulinum toxin than patients diagnosed with primary blepharospasm.SYDNEY -- Patients with blepharospasm, an involuntary closure of the eyelid caused by spasms of the ocular muscles, can get relief with injections of botulinum toxin, researchers found.
Scores on the Jankovic Rating Scale dropped from a baseline of 1.96 to 1.34 (P=0.0018) for all 27 consecutive patients during the 4 week trial, Achinoam Socher, PhD, of Chaim Sheba Medical Center in Tel-Hashomer, Israel, reported here at the International Conference of Parkinson's Disease and Movement Orders.
The patients all scored significantly better on various standard assessment instruments, the research team noted in a poster presentation: Scores on the Blepharospasm Disability Scale decreased from 10.54 to 9.29 (P=0.045)Scores on the Blepharospasm Movement Scale decreased from 5.04 to 4.00 (P=0.039)Scores on the Severity Rating Scale dropped from 1.61 to 1.19 (P=0.013)Scores on the Blepharospasm Disability Index decreased from 5.22 to 4.11 (P=0.147, ns)The blink rate decreased from 30 to 21.86 (P=0.023), largely driven by a reduction in blink rate among those with Parkinson's disease who did not undergo deep brain stimulation (P=0.22)
In addition, 21 of the 27 patients appeared to have achieved improvement in their condition on the Clinician Global Impression of Change outcome measure.
"In this study, we found that botulinum toxin A was an effective treatment for blepharospasm," the researchers reported. They did acknowledge the small numbers of patients in their study. "Larger studies are needed to assess the effect of botulinum toxin A on Parkinson's disease patients in comparison to other patients suffering from blepharospasm."
The researchers stratified patients by types of blepharospasm, identifying 10 with primary disease; 6 with blepharospasm secondary to Parkinson's disease; 6 with Parkinson's disease treated with deep brain stimulation, and 6 with various other types of blepharospasm.
There were 15 men in the study and 12 women. The average age was 65.1 years, and the patients had been diagnosed with blepharospasm for an average of 7.7 years prior to undergoing the treatment at the clinic.
The patients were enrolled consecutively and their outcomes were videotaped and then read by outside neurologists who were unaware of etiology. They were evaluated prior to start of therapy and after 4 weeks of treatment. They received one treatment course during that time frame.
Socher and colleagues from Tel Aviv University determined that patients who had blepharospasm secondary to Parkinson's disease appeared to achieve greater relief of the condition than patients diagnosed with primary blepharospasm.
"Blepharospasm occurs frequently in older individuals and in patients with Parkinson's disease and in dystonia patients. It can arise due to both the disease and from treatments for the disease," said Francesca Morgante, MD, assistant professor of neurology at the University of Messina in Sicily, Italy.
"Botulinum toxin works very well in these patients to control blepharospasm. I use it in my patients," she told MedPage Today.
Socher and Morgante had no disclosures.
Primary source: Movement Disorders Society
Source reference:
Faust-Socher A, et al "Botulium toxin treatment for blepharospasm" MDS 2013.
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