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Botulinum toxin for benign essential blepharospasm: A systematic review and an algorithmic approach
Y A Rayess1, C J Awaida2, S F Jabbour2
1Department of Plastic and Reconstructive Surgery, Faculty of Medicine, Saint-Joseph University, Paris Saint-Joseph Hospital, Paris, France.
Revue Neurologique
|July 14, 2020
Summary
This review found botulinum toxin injections are safe for benign essential blepharospasm. Targeting the pretarsal muscle is key for effective treatment.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Standardized treatment approaches for benign essential blepharospasm using botulinum toxin are lacking.
- Existing literature presents controversies regarding optimal botulinum toxin treatment strategies.
Purpose of the Study:
- To systematically review and compare published data on botulinum toxin injection techniques for benign essential blepharospasm.
- To identify best practices and potential areas for standardization in treatment.
Main Methods:
- A comprehensive Medline database search was conducted on October 3, 2018.
- Included studies provided detailed descriptions of botulinum toxin injection techniques for benign essential blepharospasm.
Main Results:
- Five studies involving 854 patients were analyzed.
- Onabotulinumtoxin A and abobotulinumtoxin A were used; injections primarily targeted the pretarsal orbicularis oculi muscle.
- Ptosis was a transient, dose-dependent adverse event, more common with preseptal injections.
Conclusions:
- Botulinum toxin injections represent a safe and non-invasive treatment for benign essential blepharospasm.
- The pretarsal orbicularis oculi muscle is identified as a critical target for effective treatment.
- An algorithmic approach to treatment was developed, though further randomized controlled trials are recommended.
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