Meige's syndrome: acute and chronic responses to clonazepan and anticholinergics

Relief of blepharospasm was achieved with clonazepan (CNZ, 1 mg i.v.) and benzhexol (BH, 5 mg i.m.) by acute parenteral administration in 5 cases of Meige's syndrome. Improvement was greater with CNZ, mean value on a quantitative scale 100%, than for BH (84.1%). Both drugs were less effective on the associated oromandibular dystonia (OMD) observed in 3 of the cases, relief again being greater when using CNZ (87.3%) compared to BH (58.3%). Intravenous administration of CNZ predicted the response to prolonged oral medication (6 mg/day) in 3 of the cases. Though both blepharospasm and OMD are thought to represent focal dystonia at different body sites, the extent of improvement achieved with these drugs at the dosage employed differed markedly.