AIM:To investigate the relationship between benign essential blepharospasm(BEB)symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin typ...AIM:To investigate the relationship between benign essential blepharospasm(BEB)symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin type A(BoNT/A)can impact psychological symptoms.METHODS:This prospective interventional case series recruited 61 adults with evidence of BEB.Patients were administered the Jankovic Rating Scale(JRS),the Blepharospasm Disability Index(BSDI),Personal Health Questionnaire Depression Scale(PHQ-8),Generalized Anxiety Disorder 7-item scale(GAD-7)and the Athens insomnia scale(AIS)to evaluate the severity of BEB symptoms,depression,anxiety and sleep disorder before and 1wk,1,3mo after the BoNTA treatment.Statistical analysis was performed to assess the relationships between changes in the survey scores.RESULTS:The mean score for JRS,BSDI,PHQ-8,and GAD-7 improved significantly(P<0.0001),respectively,compared to the initial visit at follow-up.At baseline,worse BSDI scores were correlated with worse GAD-7 and PHQ-8,but not with worse AIS.At 1mo follow-up visit,there was no correlation between change in BSDI and PHQ-8/AIS,the change in GAD-7 showed a mild association with change in BSDI.The change in BSDI was correlated with the change in both PHQ-8 and GAD-7 in the subgroup of patients without a prior diagnosis of depression or anxiety.Patient satisfaction with BoNT/A treatment reached the highest at 1mo of follow-up(83.6%,51/61).CONCLUSION:BEB may lead to psychological diseases.BoNT/A can significantly improve motor and non-motor symptoms of BEB,which emphasize the effectiveness of BoNT/A and therefore pave the way for its use in the field of psychiatry.However,further research is needed to confirm these findings and understand the underlying mechanisms.展开更多
[Objectives]To observe the clinical effect of acupuncture on blepharospasm.[Methods]72 patients were randomly divided into treatment group and control group with 36 cases in each group.In the treatment group,Shenmai,Z...[Objectives]To observe the clinical effect of acupuncture on blepharospasm.[Methods]72 patients were randomly divided into treatment group and control group with 36 cases in each group.In the treatment group,Shenmai,Zhaohai,Fengchi,Taichong,Fuyang,Jiaoxin and Jingming were selected as the main acupoints,while in the control group,routine acupoints were selected.With 4 weeks as a course of treatment,the two groups were compared after a course of treatment.The clinical effect of primary blepharospasm,blepharospasm intensity and scores of Hamilton Depression Scale were compared between the two groups before and after treatment.[Results]After treatment,the clinical efficacy of the two groups were significantly improved compared with that before treatment,the effective rate of the control group was 75.00%,the effective rate of the treatment group was 88.89%,indicating that the effective rate of control group was lower than that of the treatment group(P<0.05);after treatment,the degree of blepharospasm in both groups was significantly lower than that before treatment(P<0.05),and the treatment group had better effect in improving primary blepharospasm;the score of Hamilton depression scale in control group was lower than that in observation group(P<0.05).[Conclusions]The clinical curative effect of acupuncture at Yinqiao and Yangqiao meridians was better than that of conventional acupoints selected in relieving mild and moderate blepharospasm;it could definitely reduce the intensity of blepharospasm and relieve anxiety and depression of patients,so it is worthy of clinical promotion.展开更多
Background:Benign essential blepharospasm(BEB),aberrant facial nerve degeneration and hemifacial spasm(HFS)are all examples dystonia which,though not life-threatening,can have a significant impact on patient quality o...Background:Benign essential blepharospasm(BEB),aberrant facial nerve degeneration and hemifacial spasm(HFS)are all examples dystonia which,though not life-threatening,can have a significant impact on patient quality of life.The need for reliable self-rating surveys to monitor functional disability is fundamental.The Blepharospasm Disability Index(BSDI)is already a widely utilised and validated selfrating score for blepharospasm whilst the functional disability score(FDS)requires further validation.The principle aim of this study is to repeat validation of the FDS against the BSDI,which has been validated by several groups since its original description but only in patients with BEB.Methods:A randomised blinded prospective cohort study was conducted at a single unit on 38 patients with BEB,aberrant facial nerve degeneration and HFS.Patients were blinded to complete the FDS followed by the BSDI or the BSDI followed by the FDS with a 30-minute interval.Results:Both the FDS and BSDI were found to be reliable with high internal consistency and test-retest reliability.Both scales were also found to be moderately correlated with the Jankovic disease severity score.Conclusions:This study is the first to use the FDS as a rating scale in patients with HFS and aberrant facial nerve degeneration.It is also the first study to formally validate the FDS as an acceptable rating scale for patients with dystonia and in particular it provides validation for its use in patients with HFS and aberrant facial nerve degeneration.展开更多
Purpose:To observe the efficacy of the combined treatment of carbamazepine and botulinum toxin A for blepharospasm and hemifacial spasm. Methods:Fifty-eight patients with either blepharospasm or hemifacial spasm were ...Purpose:To observe the efficacy of the combined treatment of carbamazepine and botulinum toxin A for blepharospasm and hemifacial spasm. Methods:Fifty-eight patients with either blepharospasm or hemifacial spasm were randomly divided into treatment and control groups. In the treatment group, 30 patients were administered with local intramuscular injections of botulinum toxin A and oral carbamazepine 100 mg/time,3 times/day for 60 days. Twenty-eight subjects in the control group under-went local intramuscular injections of botulinum toxin A only. Results:After combined treatment, the complete remission rate was 90%, which was significantly higher than that of the of the control group (67.9% , P<0.05,χ2 =4.733). However, no statistical significance was noted regarding the duration of therapeutic effects between the treatment group (range 14～40 weeks; 19.2 weeks on average) and control group (range 12～36 weeks; 18 weeks on average). Conclusion:The combined therapy of carbamazepine and topical injections of botulinum toxin A had increased efficacy in the treatment of blepharospasm or hemifacial spasm, but had no significant effect in terms of the duration of the therapeutic effect.展开更多
Objective:To observe the clinical effect of aligned needling method in treating idiopathic blepharospasm.Methods:Seventy-eight patients with idiopathic blepharospasm were randomized into two groups.Forty-six cases in ...Objective:To observe the clinical effect of aligned needling method in treating idiopathic blepharospasm.Methods:Seventy-eight patients with idiopathic blepharospasm were randomized into two groups.Forty-six cases in the treatment group were treated with aligned needling method applied to orbicularis oculi muscles;32 cases in the control group were treated with anticonvulsants.Therapeutic effects were compared after 3 treatment courses.Results:The total effective rate was 93.5%in the treatment group versus75.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Aligned needling method applied to orbicularis oculi muscle has better therapeutic effect than anticonvulsants in treating blepharospasm.展开更多
Objective:To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm(BEB).Methods:A prospective randomized controlled trial was performed.A total of 105 pa...Objective:To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm(BEB).Methods:A prospective randomized controlled trial was performed.A total of 105 participants were randomized 1:1:1 into an acupuncture group,a herbal medicine group and an acupuncture plus herbal medicine group.Participants in the acupuncture group received manual acupuncture treatment,twice a week.Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang,oral administration,once a day.Participants in the acupuncture plus herbal medicine group received both treatments.The therapeutic effects of the three groups were evaluated after four weeks of treatment.The primary outcome was the Jankovic rating scale(JRS)score,and the secondary outcome was the blepharospasm disability index(BSDI)score.Results:After four weeks of treatment,the JRS total scores significantly decreased in all three groups versus baseline(P<0.05).A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group(P<0.05),but there was no significant difference between the acupuncture group and the herbal medicine group(P>0.05).The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group(P<0.05).The reduction in the JRS frequency score was not significantly different among the three groups(P>0.05).The BSDI scores significantly decreased in all three groups versus baseline(P<0.05),but the reduction in the BSDI score was insignificantly different among the three groups(P>0.05).Conclusion:It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination.The combination therapy shows a more significant effect than either of the treatment alone.展开更多
Background:Focal dystonia is a neurological disorder characterized by unwanted muscle spasms.Blepharospasm is a focal dystonia producing an involuntary closure of the eyelid.Its etiology is unknown.Objective:To invest...Background:Focal dystonia is a neurological disorder characterized by unwanted muscle spasms.Blepharospasm is a focal dystonia producing an involuntary closure of the eyelid.Its etiology is unknown.Objective:To investigate if there are structural changes in the white and grey matter of blepharospasm patients,and if the changes are related to disease features.Methods:T1 and diffusion-weighted magnetic resonance imaging scans were collected from 14 female blepharospasm patients and 14 healthy matched controls.Grey matter volumes,fractional anisotropy(FA),and mean diffusivity maps were compared between the groups.Based on grey matter differences within the facial portion of the primary motor cortex,the corticobulbar tract was traced and compared between groups.Results:Changes in grey matter in patients included the facial portion of the sensorimotor area and anterior cingulate gyrus.These changes did not correlate with disease duration.Corticobulbar tract volume and peak tract connectivity were decreased in patients compared with controls.There were no significant differences in FA or mean diffusivity between groups.Conclusions:Grey matter changes within the primary sensorimotor and the anterior cingulate cortices in blepharospasm patients may help explain involuntary eyelid closure and the abnormal sensations often reported in this condition.展开更多
基金Supported by the National Natural Science Foundation of China(No.82000938No.82000857).
文摘AIM:To investigate the relationship between benign essential blepharospasm(BEB)symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin type A(BoNT/A)can impact psychological symptoms.METHODS:This prospective interventional case series recruited 61 adults with evidence of BEB.Patients were administered the Jankovic Rating Scale(JRS),the Blepharospasm Disability Index(BSDI),Personal Health Questionnaire Depression Scale(PHQ-8),Generalized Anxiety Disorder 7-item scale(GAD-7)and the Athens insomnia scale(AIS)to evaluate the severity of BEB symptoms,depression,anxiety and sleep disorder before and 1wk,1,3mo after the BoNTA treatment.Statistical analysis was performed to assess the relationships between changes in the survey scores.RESULTS:The mean score for JRS,BSDI,PHQ-8,and GAD-7 improved significantly(P<0.0001),respectively,compared to the initial visit at follow-up.At baseline,worse BSDI scores were correlated with worse GAD-7 and PHQ-8,but not with worse AIS.At 1mo follow-up visit,there was no correlation between change in BSDI and PHQ-8/AIS,the change in GAD-7 showed a mild association with change in BSDI.The change in BSDI was correlated with the change in both PHQ-8 and GAD-7 in the subgroup of patients without a prior diagnosis of depression or anxiety.Patient satisfaction with BoNT/A treatment reached the highest at 1mo of follow-up(83.6%,51/61).CONCLUSION:BEB may lead to psychological diseases.BoNT/A can significantly improve motor and non-motor symptoms of BEB,which emphasize the effectiveness of BoNT/A and therefore pave the way for its use in the field of psychiatry.However,further research is needed to confirm these findings and understand the underlying mechanisms.
文摘[Objectives]To observe the clinical effect of acupuncture on blepharospasm.[Methods]72 patients were randomly divided into treatment group and control group with 36 cases in each group.In the treatment group,Shenmai,Zhaohai,Fengchi,Taichong,Fuyang,Jiaoxin and Jingming were selected as the main acupoints,while in the control group,routine acupoints were selected.With 4 weeks as a course of treatment,the two groups were compared after a course of treatment.The clinical effect of primary blepharospasm,blepharospasm intensity and scores of Hamilton Depression Scale were compared between the two groups before and after treatment.[Results]After treatment,the clinical efficacy of the two groups were significantly improved compared with that before treatment,the effective rate of the control group was 75.00%,the effective rate of the treatment group was 88.89%,indicating that the effective rate of control group was lower than that of the treatment group(P<0.05);after treatment,the degree of blepharospasm in both groups was significantly lower than that before treatment(P<0.05),and the treatment group had better effect in improving primary blepharospasm;the score of Hamilton depression scale in control group was lower than that in observation group(P<0.05).[Conclusions]The clinical curative effect of acupuncture at Yinqiao and Yangqiao meridians was better than that of conventional acupoints selected in relieving mild and moderate blepharospasm;it could definitely reduce the intensity of blepharospasm and relieve anxiety and depression of patients,so it is worthy of clinical promotion.
文摘Background:Benign essential blepharospasm(BEB),aberrant facial nerve degeneration and hemifacial spasm(HFS)are all examples dystonia which,though not life-threatening,can have a significant impact on patient quality of life.The need for reliable self-rating surveys to monitor functional disability is fundamental.The Blepharospasm Disability Index(BSDI)is already a widely utilised and validated selfrating score for blepharospasm whilst the functional disability score(FDS)requires further validation.The principle aim of this study is to repeat validation of the FDS against the BSDI,which has been validated by several groups since its original description but only in patients with BEB.Methods:A randomised blinded prospective cohort study was conducted at a single unit on 38 patients with BEB,aberrant facial nerve degeneration and HFS.Patients were blinded to complete the FDS followed by the BSDI or the BSDI followed by the FDS with a 30-minute interval.Results:Both the FDS and BSDI were found to be reliable with high internal consistency and test-retest reliability.Both scales were also found to be moderately correlated with the Jankovic disease severity score.Conclusions:This study is the first to use the FDS as a rating scale in patients with HFS and aberrant facial nerve degeneration.It is also the first study to formally validate the FDS as an acceptable rating scale for patients with dystonia and in particular it provides validation for its use in patients with HFS and aberrant facial nerve degeneration.
基金The Science and Technology Projects of GuangdongProvince,China (2010B060500006)
文摘Purpose:To observe the efficacy of the combined treatment of carbamazepine and botulinum toxin A for blepharospasm and hemifacial spasm. Methods:Fifty-eight patients with either blepharospasm or hemifacial spasm were randomly divided into treatment and control groups. In the treatment group, 30 patients were administered with local intramuscular injections of botulinum toxin A and oral carbamazepine 100 mg/time,3 times/day for 60 days. Twenty-eight subjects in the control group under-went local intramuscular injections of botulinum toxin A only. Results:After combined treatment, the complete remission rate was 90%, which was significantly higher than that of the of the control group (67.9% , P<0.05,χ2 =4.733). However, no statistical significance was noted regarding the duration of therapeutic effects between the treatment group (range 14～40 weeks; 19.2 weeks on average) and control group (range 12～36 weeks; 18 weeks on average). Conclusion:The combined therapy of carbamazepine and topical injections of botulinum toxin A had increased efficacy in the treatment of blepharospasm or hemifacial spasm, but had no significant effect in terms of the duration of the therapeutic effect.
文摘Objective:To observe the clinical effect of aligned needling method in treating idiopathic blepharospasm.Methods:Seventy-eight patients with idiopathic blepharospasm were randomized into two groups.Forty-six cases in the treatment group were treated with aligned needling method applied to orbicularis oculi muscles;32 cases in the control group were treated with anticonvulsants.Therapeutic effects were compared after 3 treatment courses.Results:The total effective rate was 93.5%in the treatment group versus75.0%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Aligned needling method applied to orbicularis oculi muscle has better therapeutic effect than anticonvulsants in treating blepharospasm.
文摘Objective:To evaluate the therapeutic efficacy of acupuncture plus Dang Gui Bu Xue Qu Feng Tang for benign essential blepharospasm(BEB).Methods:A prospective randomized controlled trial was performed.A total of 105 participants were randomized 1:1:1 into an acupuncture group,a herbal medicine group and an acupuncture plus herbal medicine group.Participants in the acupuncture group received manual acupuncture treatment,twice a week.Participants in the herbal medicine group received Dang Gui Bu Xue Qu Feng Tang,oral administration,once a day.Participants in the acupuncture plus herbal medicine group received both treatments.The therapeutic effects of the three groups were evaluated after four weeks of treatment.The primary outcome was the Jankovic rating scale(JRS)score,and the secondary outcome was the blepharospasm disability index(BSDI)score.Results:After four weeks of treatment,the JRS total scores significantly decreased in all three groups versus baseline(P<0.05).A greater reduction in the JRS total score was reported in participants in the acupuncture plus herbal medicine group(P<0.05),but there was no significant difference between the acupuncture group and the herbal medicine group(P>0.05).The acupuncture plus herbal medicine group had a greater decrease in the JRS severity score than the herbal medicine group(P<0.05).The reduction in the JRS frequency score was not significantly different among the three groups(P>0.05).The BSDI scores significantly decreased in all three groups versus baseline(P<0.05),but the reduction in the BSDI score was insignificantly different among the three groups(P>0.05).Conclusion:It is effective in the treatment of BEB either to use acupuncture and Dang Gui Bu Xue Qu Feng Tang alone or in combination.The combination therapy shows a more significant effect than either of the treatment alone.
基金This research was supported by the Intramural Research Program of the National Institute of Neurological Disorders and Stroke,National Institutes of Health.
文摘Background:Focal dystonia is a neurological disorder characterized by unwanted muscle spasms.Blepharospasm is a focal dystonia producing an involuntary closure of the eyelid.Its etiology is unknown.Objective:To investigate if there are structural changes in the white and grey matter of blepharospasm patients,and if the changes are related to disease features.Methods:T1 and diffusion-weighted magnetic resonance imaging scans were collected from 14 female blepharospasm patients and 14 healthy matched controls.Grey matter volumes,fractional anisotropy(FA),and mean diffusivity maps were compared between the groups.Based on grey matter differences within the facial portion of the primary motor cortex,the corticobulbar tract was traced and compared between groups.Results:Changes in grey matter in patients included the facial portion of the sensorimotor area and anterior cingulate gyrus.These changes did not correlate with disease duration.Corticobulbar tract volume and peak tract connectivity were decreased in patients compared with controls.There were no significant differences in FA or mean diffusivity between groups.Conclusions:Grey matter changes within the primary sensorimotor and the anterior cingulate cortices in blepharospasm patients may help explain involuntary eyelid closure and the abnormal sensations often reported in this condition.
