Regionalism’s past, present, and future

Blepharospasm and hemifacial spasm: a protocol for titration of botulinum toxin dose to the individual patient and for the management of refractory cases

“…These figures compare favourably to other retrospective studies that report improvements in symptoms in 85-95% of patients. 2,3,5,20 Only eight patients stated that they were dissatisfied with the treatment, and a further 15 were lost to follow-up for unknown reasons during the 3-year period. Although 236 of patients (71.3%) experienced side effects at some stage during their treatment, the follow-up period was long (median 49 months), and the majority of these patients (137 patients) had a mild ptosis that did not interfere with the vision, or a mild lagophthalmos that did not require treatment.…”

“…2,3 With time, the phenomenon becomes more frequent until it causes difficulty with carrying out daily activities, and impairs health-related quality of life, causing social embarrassment, anxiety, and depression. [3][4][5] Rarely the spasm can cause functional blindness.…”

“…2,3 With time, the phenomenon becomes more frequent until it causes difficulty with carrying out daily activities, and impairs health-related quality of life, causing social embarrassment, anxiety, and depression. [3][4][5] Rarely the spasm can cause functional blindness. 5 A variety of treatments are available for facial dystonias: treatment of dry eye symptoms, referral to patient groups, 3 treatment with drugs including antidepressants, anxiolytics, anticonvulsants, anti-Parkinson drugs, and muscle relaxants, 6 and surgery including facial nerve avulsion, 7 orbicularis oculi myectomy, [8][9][10] and brow suspension.…”

“…[3][4][5] Rarely the spasm can cause functional blindness. 5 A variety of treatments are available for facial dystonias: treatment of dry eye symptoms, referral to patient groups, 3 treatment with drugs including antidepressants, anxiolytics, anticonvulsants, anti-Parkinson drugs, and muscle relaxants, 6 and surgery including facial nerve avulsion, 7 orbicularis oculi myectomy, [8][9][10] and brow suspension. 11,12 Since the mid-1980s, the treatment of facial dystonias has been revolutionised following the introduction of botulinum toxin, 13 which has been shown to be very effective in the treatment of benign essential blepharospasm and hemifacial spasm.…”

Blefaroespasmo essencial benigno

“…Trata-se de uma doença multifatorial em sua origem e manifestação. Alguns pacientes podem apresentar também contrações involuntárias de outros grupos musculares, caracterizando a síndrome de Meige, síndrome de Brueghel ou a distonia orofacial idiopática (3) .Distonia é o termo usado para descrever um grupo de doenças caracterizado por espasmos musculares involuntários que produzem movimentos e posturas anormais. Esses espasmos podem afetar uma pequena parte do corpo como os olhos, pescoço ou mão (distonias focais), duas partes vizinhas como o pescoço e um braço (distonias segmentares), um lado inteiro do corpo (hemidistonia) ou todo o corpo (distonia generalizada).…”