Prevalence of Blepharospasm and Apraxia of Eyelid Opening in Patients with Parkinsonism, Cervical Dystonia and Essential Tremor

Rana, Abdul-Qayyum; Kabir, Ashish; Doğu, Okan; Patel, Ami; Khondker, Sumaiya

doi:10.1159/000341621

Cited by 43 publications

(34 citation statements)

References 36 publications

(26 reference statements)

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“…AEO is often seen in extrapyramidal diseases, such as PD, progressive supranuclear palsy, and multiple system atrophy (1,8). Many points remain unclear, including the anatomical lesion and its mechanism.…”

Section: Discussionmentioning

confidence: 99%

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

et al. 2015

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We herein report three cases of Parkinson's disease associated with difficulty in eyelid opening, referred to as apraxia of eyelid opening (AEO), which improved after aripiprazole treatment. In case 1, aripiprazole was administered as a psychiatric treatment. It proved to be effective in AEO with blepharospasm. In case 2 and case 3, the patients experienced AEO without blepharospasm, and a significant improvement was observed after aripiprazole treatment. In this study, the aripiprazole dosage ranged between 3 and 9 mg/day. This is the first report of aripiprazole as a potentially effective treatment for AEO in Parkinson's disease.

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Section: Discussionmentioning

confidence: 99%

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

et al. 2015

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“…Nevertheless, secondary cases may be important in providing clues as to the origin of the condition. Blepharospasm may follow focal lesions in multiple brain regions, including the thalamus, basal ganglia, lower brain stem, cerebellum, midbrain, and cortex, or may develop in patients with PD or tardive dyskinesia . Finally, secondary blepharospasm may arise from conditions associated with lid weakness, such as facial palsy and myasthenia …”

Section: Etiologymentioning

confidence: 99%

Blepharospasm 40 years later

et al. 2017

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Forty years ago, C.D. Marsden proposed that blepharospasm should be considered a form of adult-onset focal dystonia. In the present paper, we provide a comprehensive overview of the findings regarding blepharospasm reported in the past 40 years. Although prolonged spasms of the orbicularis oculi muscles remain the clinical hallmark of blepharospasm, patients with blepharospasm may be characterized by various types of involuntary activation of periocular muscles. In addition to motor features, blepharospasm patients may also have nonmotor manifestations, including psychiatric, mild cognitive, and sensory disturbances. The various motor and nonmotor symptoms are not present in all patients, suggesting that blepharospasm is phenomenologically a heterogeneous condition. This emphasizes the need for tools for severity assessment that take into account both motor and nonmotor manifestations. The cause of blepharospasm remains elusive, but several lines of evidence indicate that blepharospasm is a multifactorial condition in which one, or several, as yet unknown genes together with epigenetic and environmental factors combine to reach the threshold of the disease. Although blepharospasm was originally believed to be solely a basal ganglia disorder, neurophysiological and neuroimaging evidence point to anatomical and functional involvement of several brain regions. The contribution of multiple areas has led to the hypothesis that blepharospasm should be considered as a network disorder, and this might reflect the varying occurrence of motor and nonmotor manifestations in blepharospasm patients. Despite advances in the aetiology and pathophysiology, treatment remains symptomatic.

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“…Any model for pathogenesis should take into account several nongenetic factors. BL is associated with focal lesions in the nervous system, exposure to certain drugs, and degenerative disorders . Eye disorders, particularly dry eye, commonly precede BL .…”

Section: Adult‐onset Focal Dystoniasmentioning

confidence: 99%

The focal dystonias: Current views and challenges for future research

et al. 2013

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The most common forms of dystonia are those that develop in adults and affect a relatively isolated region of the body. Although these adult-onset focal dystonias are most prevalent, knowledge of their etiologies and pathogenesis has lagged behind some of the rarer generalized dystonias, where the identification of genetic defects has facilitated both basic and clinical research. This summary provides a brief review of the clinical manifestations of the adult-onset focal dystonias, focussing attention on less well-understood clinical manifestations that need further study. It also provides a simple conceptual model for the similarities and differences among the different adult-onset focal dystonias, as a rationale for lumping them together as a class of disorders while at the same time splitting them into subtypes. The concluding section outlines some of the most important research questions for the future. Answers to these questions are critical for advancing our understanding of this group of disorders, and for developing novel therapeutics.

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Prevalence of Blepharospasm and Apraxia of Eyelid Opening in Patients with Parkinsonism, Cervical Dystonia and Essential Tremor

Cited by 43 publications

References 36 publications

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

Aripiprazole Can Improve Apraxia of Eyelid Opening in Parkinson's Disease

Blepharospasm 40 years later

The focal dystonias: Current views and challenges for future research

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