AI Article Synopsis
- Blepharospasm is commonly found in Parkinsonism cases, like progressive supranuclear palsy, and patients generally respond well to botulinum toxin treatment.
- Some patients may stop responding to botulinum despite previous effectiveness, often due to apraxia of eyelid opening, which complicates treatment.
- Combining treatments like eyelid crutches or myomectomy with botulinum toxin has shown to yield better results in these cases than using just one treatment alone.
Article Abstract
Blepharospasm is seen in many cases of Parkinsonism including progressive supranuclear palsy. These patients usually respond well to botulinum toxin, however some patients subsequently fail to respond to even higher doses of botulinum toxin after an initial good response. They should not be considered failure of treatment with botulinum toxin, as a significant number of these patients have underlying apraxia of eyelid opening in addition to blepharospasm, which may be the cause of failure to respond to botulinum toxin. Combination of eyelid crutches or myomectomy with botulinum toxin is more effective in these patients as compared to an individual treatment modality. In this report, we present two patients with progressive supranuclear palsy who failed to respond to botulinum toxin because they had underlying apraxia of lid opening. Partial myomectomy in one patient and eyelid crutches in the other in combination with botulinum toxin lead to a much better response to botulinum toxin.
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| http://dx.doi.org/10.1007/s13760-012-0019-z | DOI Listing |
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