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. 2011 Mar;18(3):382-6.
doi: 10.1111/j.1468-1331.2010.03161.x.

Clinical features of patients with blepharospasm: a report of 240 patients

E L Peckham  1 , G Lopez, E A Shamim, S Pirio Richardson, S Sanku, R Malkani, M Stacy, P Mahant, A Crawley, A Singleton, M Hallett
Affiliations

Clinical features of patients with blepharospasm: a report of 240 patients

E L Peckham et al. Eur J Neurol. 2011 Mar.

Abstract

Background and purpose: To characterize patients with benign essential blepharospasm (BEB) by diagnosis, environmental risk factors, and family history.

Methods: Two hundred and forty patients with BEB were evaluated through a clinical examination and questionnaire. The questionnaire reviewed personal medical history, demographic factors, risk factors for the development of blepharospasm and family history of dystonia and other neurological conditions.

Results: Benign essential blepharospasm was more commonly found in women (2.8:1) and 93% of the patients were Caucasian. Fifty percent had pure BEB, 31% had BEB/Meige's syndrome, and 4% had BEB and eyelid opening apraxia (+/- Meige's syndrome). A minority of patients reported preceding photophobia (25%) or other eye conditions (22%). The majority were non-smokers, had no exposure to anti-emetic or antipsychotic agents, had a normal birth history, and had no history of head trauma. Seventy-two percent did report a stressful event immediately prior to the development of symptoms. Treatments reported included botulinum toxin (BoNT), oral medications, surgical procedures, and acupuncture. Thirty-two percent of patients reported a family history of focal dystonia, and BEB was the most commonly reported.

Conclusion: This study confirms previous reports of usual age, sex, caffeine and tobacco use, and family history in patients with blepharospasm. New findings include a report on occupation, lower reports of preceding eye conditions and photophobia, and higher reported stressful events. Further, this study shows a change in treatment with an increase in BoNT use and decrease in surgical procedures.

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Conflict of interest statement

Other potential conflict of interest: Dr. Peckham has received funding from St. Jude Medical and Ortho-McNeill Janssen for clinical trial research in Parkinson's disease and essential tremor. Drs. Lopez, Pirio Richardson, Malkani and Singleton have nothing to disclose. Dr. Shamim participated in Allergan speakers bureau training and has participated in research sponsored by Allergan but has not received any personal financial compensation from Allergan. Ms. Sanku has nothing to disclose. Dr. Stacy has received grant/research support from Novartis, Schering-Plough, Parkinson's Study Group, Ceregene and Impax. He has served as a consultant for Allergan, Boeringher-Ingelheim, GE, Novartis, Osmotica, and Synosia. He has been on the speakers' bureau for Allergan, Boeringher-Ingelheim, GlaxoSmithKline, TEVA, and Novartis and has been on the safety monitoring board for Biogen and Neurologix. Dr. Mahant has served as part of the Allergan Speakers bureau. Mr. Crawley has nothing to disclose. Dr. Hallett has received personal compensation or travel expenses for activities with Neurotoxin Institute, John Templeton Foundation, Parkinson's and Ageing Research Foundation, University of Pennsylvania, Thomas Jefferson University, Baylor College of Medicine, American Academy of Neurology, Medical University of South Carolina, Northshore-Long Island Jewish Hospital, American Clinical Neurophysiology Society, Columbia University, University of Alabama, Blackwell Publisher, Cambridge University Press, Springer Verlag, Taylor & Francis Group, Oxford University Press, John Wiley & Sons, and Elsevier as an advisory board member, an editor, a writer, or a speaker. Dr. Hallett has received license fee payments from the National Institutes of Health for the H-coil, a type of coil for magnetic stimulation. Dr. Hallett and his wife held stock and/or stock options in Agilent Technologies, Amgen, Amylin Pharmaceuticals, Merck & Co., Monsanto Co New Del, Sanofi Aventis Adr., Coventry Health Care Inc., Sigma Aldrich Corp., Warner Chilcott Ltd., Pfizer Inc, Genentech, Inc., United Health Group, St. Jude Medical, and Eli Lilly & Company. Dr. Hallett's wife received personal compensation or travel expenses from Bolchazy-Carducci, US Naval Academy, Charles County Public Schools, College of Notre Dame, Oxford University Press, Classical Association of New England Summer Institute, Princeton University, Trinity University, and Johns Hopkins University for writing, editing or speaking.

Figures

Figure 1
Figure 1
Family History of Neurological Conditions:
See this image and copyright information in PMC

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Supplementary concepts