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Clinical features of patients with blepharospasm: a report of 240 patients
Authors:E. L. Peckham  G. Lopez  E. A. Shamim  S. Pirio Richardson  S. Sanku  R. Malkani  M. Stacy  P. Mahant  A. Crawley  A. Singleton  M. Hallett
Abstract:Background and purpose: To characterize patients with benign essential blepharospasm (BEB) by diagnosis, environmental risk factors, and family history. Methods: Two hundred and forty patients with BEB were evaluated through a clinical examination and questionnaire. The questionnaire reviewed personal medical history, demographic factors, risk factors for the development of blepharospasm and family history of dystonia and other neurological conditions. Results: Benign essential blepharospasm was more commonly found in women (2.8:1) and 93% of the patients were Caucasian. Fifty percent had pure BEB, 31% had BEB/Meige’s syndrome, and 4% had BEB and eyelid opening apraxia (+/− Meige’s syndrome). A minority of patients reported preceding photophobia (25%) or other eye conditions (22%). The majority were non‐smokers, had no exposure to anti‐emetic or antipsychotic agents, had a normal birth history, and had no history of head trauma. Seventy‐two percent did report a stressful event immediately prior to the development of symptoms. Treatments reported included botulinum toxin (BoNT), oral medications, surgical procedures, and acupuncture. Thirty‐two percent of patients reported a family history of focal dystonia, and BEB was the most commonly reported. Conclusion: This study confirms previous reports of usual age, sex, caffeine and tobacco use, and family history in patients with blepharospasm. New findings include a report on occupation, lower reports of preceding eye conditions and photophobia, and higher reported stressful events. Further, this study shows a change in treatment with an increase in BoNT use and decrease in surgical procedures.
Keywords:blepharospasm  botulinum toxin  dystonia  risk factors
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