Update on blepharospasm: report from the BEBRF International Workshop

Abstract

This review updates understanding and research on blepharospasm, a subtype of focal dystonia. Topics covered include clinical aspects, pathology, pathophysiology, animal models, dry eye, photophobia, epidemiology, genetics, and treatment. Blepharospasm should be differentiated from apraxia of eyelid opening. New insights into pathology and pathophysiology are derived from different types of imaging, including magnetic resonance studies. Physiologic studies indicate increased plasticity and trigeminal sensitization. While botulinum neurotoxin injections are the mainstay of therapy, other therapies are on the horizon.

Figure 1 Gray matter increase bilaterally in the putamen in blepharospasm Results are projected on (A) coronal and (B) axial slices of the study-specific averaged T1-image in a standard stereotactic space derived from all the 32 study participants. Reported from Etgen et al. with permission from BMJ Publishing Group Ltd.

Figure 2 Enhanced long-term potentiation-like plasticity of the trigeminal blink reflex circuit in blepharospasm Magnitude of the R2 component of the blink reflex at baseline (T0) and 30 minutes (T30) and 60 minutes (T60) following a session of high frequency stimulation of the supraorbital nerve timed to occur during the blink reflex. Average data on the left and individual data on the right. Reprinted from Quartarone et al. with permission from the Journal of Neuroscience.

Figure 3 Spectral transmission characteristics of lens tint 6 (A) and FL-41 lens (B) Reprinted from Herz and Yen with permission from Elsevier, copyright 2005.