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Blepharospasm and Hemifacial Spasm.

Boghen1, Lesser

  • 1Centre Hospitalier de l'Universite de Montreal, 3840 St-Urbain Street, Montreal, Quebec, H2W 1T8, Canada.

Current Treatment Options in Neurology
|November 30, 2000
PubMed
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Botulinum toxin is the primary treatment for blepharospasm and hemifacial spasm. For refractory cases, oral medications or surgical interventions like myectomy or microvascular decompression may be considered.

Area of Science:

  • Neurology
  • Ophthalmology
  • Plastic Surgery

Background:

  • Blepharospasm involves involuntary eyelid closure, while hemifacial spasm causes facial twitches.
  • Apraxia of eyelid opening presents a distinct challenge in eyelid function.

Purpose of the Study:

  • To outline effective treatment strategies for blepharospasm and hemifacial spasm.
  • To provide a treatment algorithm for patients unresponsive to initial therapies.

Main Methods:

  • Review of current treatment modalities for blepharospasm and hemifacial spasm.
  • Sequential trial of oral medications (trihexyphenidyl, baclofen, clonazepam, tetrabenazine) for refractory blepharospasm.
  • Surgical options including myectomy, frontalis suspension, and microvascular decompression.

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Main Results:

  • Botulinum toxin is the first-line treatment for both conditions.
  • Oral medications offer an alternative for a minority of blepharospasm patients.
  • Surgery is reserved for cases refractory to medical management.

Conclusions:

  • A stepwise approach, starting with botulinum toxin and progressing to oral medications or surgery, optimizes outcomes.
  • Surgical interventions provide solutions for patients with severe, intractable spasms.
  • Doxorubicin chemomyectomy shows promise but requires further research.