Chemodenervation for the Treatment of Facial Dystonia

Bilyk, Jurij R.; Yen, Michael T.; Bradley, Elizabeth; Wladis, Edward J.; Mawn, Louise A.

doi:10.1016/j.ophtha.2018.03.013

Cited by 22 publications

(7 citation statements)

References 37 publications

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“…The efficacy of botulinum toxin administration in EB patients is usually assessed using grading systems, such as the JRS, the most commonly used grading system for EB [10][11][12][13]. Its assessment is represented by a sum score that summarizes frequency and severity [14].…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Facial dystonias may effectively be treated with periocular subcutaneous injection of botulinum toxin Vol:. (1234567890) [5,11,12]. These injections produce few local complications, such as ecchymosis, ptosis, or diplopia, and do not generally have systemic effects [13].…”

Section: Introductionmentioning

confidence: 99%

Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

et al. 2023

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Purpose To analyze using Pentacam®, the corneal and anterior chamber changes following periocular botulinum toxin injection in patients with facial dystonia. Methods Prospective study that included patients with facial dystonia that were going to receive a periocular botulinum toxin injection for the first time or six months or more after the previous injection. A Pentacam® examination was carried out in all patients before and 4 weeks after the injection. Results Thirty-one eyes were included. Twenty-two had a diagnosis of blepharospasm and nine of hemifacial spasm. Analysis of corneal and anterior chamber parameters revealed a significant decrease in iridocorneal angle after botulinum toxin injection (from 35 ± 10º to 33.8 ± 9.7º, p = 0.022). No other corneal or anterior chamber parameters changed significantly after the injection. Conclusions Periocular botulinum toxin injection causes narrowing of the iridocorneal angle.

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“…The treatment of choice for this condition is botulinum toxin A (BTX-A) injections, which temporarily weaken the eyelid protractor muscles. [1][2][3] Objective assessment of EB patients is challenging since these patients exhibit chaotic patterns of abnormal eyelid movements, making reviewing videos and counting eyelid spasms a somewhat inaccurate method. 4 A practical tool using a smartphone and custom-made software to assess eyelid spasms in these patients has been recently reported and permits the assessment of the response to botulinum toxin injections in clinical practice with higher accuracy than human-based video review analysis.…”

mentioning

confidence: 99%

“…The treatment of choice for this condition is botulinum toxin A (BTX-A) injections, which temporarily weaken the eyelid protractor muscles. 1–3…”

mentioning

confidence: 99%

Ocular Surface Metrics in Blepharospasm Patients After Treatment With Botulinum Toxin Injections

Yabumoto

Osaki

Gameiro

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose:The purpose of this study was to assess blepharospasm patients regarding the effect of botulinum toxin in ocular surface parameters.Methods: A prospective study was performed in blepharospasm patients treated with onabotulinumtoxinA. A smartphone (iPhone 6S, Apple) and custom-made software were used to record the eyelid movements for 3 minutes in a standardized manner. Optical coherence tomography of the tear meniscus was used to assess the tear meniscus area. Tear break-up time and the Ocular Surface Disease Index questionnaire were also evaluated. Patients were assessed before and 15 days after botulinum toxin injections.Results: Forty eyes of 20 patients were evaluated. The frequency of the spontaneous eyelid movements was significantly reduced after treatment (23.18 ± 12.85 movements/ min vs. 9.29 ± 6.87 movements/min; p < 0.0001). Significant increases in the tear meniscus area (0.020 ± 0.015 mm 2 vs. 0.057 ± 0.104 mm 2 ; p = 0.01) and in break-up time (4.2 ± 1.2 seconds vs. 5.1 ± 1.3 seconds; p = 0.03) were observed 15 days after treatment. A significant reduction in the Ocular Surface Disease Index (59.05 ± 19.04 vs. 21.2 ± 19.5; p < 0.0001) was also observed.Conclusion: Significant changes in the tear meniscus area, break-up time, and Ocular Surface Disease Index after treatment reflect the effect of botulinum toxin on the lacrimal pump and in the improvement of dry eye symptoms. Reduction of eyelid spasms after treatment in blepharospasm patients was demonstrated using a smartphone and custom-made software. Thus, beyond relieving eyelid spasms, botulinum toxin injections were associated with subjective and objective improvement of dry eye parameters in patients with blepharospasm.

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Chemodenervation for the Treatment of Facial Dystonia

Cited by 22 publications

References 37 publications

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

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

Effects of the periocular botulinum toxin on the ocular surface and anterior chamber: a prospective study in patients with hemifacial spasm and blepharospasm

Ocular Surface Metrics in Blepharospasm Patients After Treatment With Botulinum Toxin Injections

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