Asymmetrical blepharospasm associated with a left frontal cortical infarct

[Secondary blepharospasm, analysis and pathophysiology of blepharospasm. French translation of the article]

PURPOSE

To localize the brain structures involved in blepharospasm.

MATERIALS AND METHODS

This is a retrospective consecutive series of brain MRI's of patients with secondary blepharospasm whose immediate past medical history included cerebrovascular accident or head trauma.

RESULTS

Six patients, including 4 with CVA with ischemic or hemorrhagic lesions of the thalamus and caudate nuclei and 2 with head trauma with contusive sequellae to the tectal plate and frontal cortical and cerebellar atrophy.

CONCLUSION

According to the literature, brain lesions associated with blepharospasm involve mainly the thalamus, head of the caudate nucleus, corpus striatum, globus pallidus, internal capsule, cerebral cortex and cerebellum. This study demonstrates that blepharospasm is associated with a lesion of a complex neural network - cortex-thalamus-globus pallidus-cortex - and does not correspond to a single, unique lesion. This network is connected with ascending and descending sensory-motor pathways and motor nuclei.

Secondary blepharospasm, analysis and pathophysiology of blepharospasm

PURPOSE

To localize the brain structures involved in blepharospasm.

MATERIALS AND METHODS

This is a retrospective consecutive series of brain MRI's of patients with secondary blepharospasm whose immediate past medical history included cerebrovascular accident or head trauma.

RESULTS

Six patients, including 4 with CVA with ischemic or hemorrhagic lesions of the thalamus and caudate nuclei and 2 with head trauma with contusive sequellae to the tectal plate and frontal cortical and cerebellar atrophy.

CONCLUSION

According to the literature, brain lesions associated with blepharospasm involve mainly the thalamus, head of the caudate nucleus, corpus striatum, globus pallidus, internal capsule, cerebral cortex and cerebellum. This study demonstrates that blepharospasm is associated with a lesion of a complex neural network - cortex-thalamus-globus pallidus-cortex - and does not correspond to a single, unique lesion. This network is connected with ascending and descending sensory-motor pathways and motor nuclei.

Observation on the clinical effect of thunder-fire moxibustion combined with acupressure on ocular muscle spasm: A clinical randomized controlled trial

INTRODUCTION

With the rapid development of social economy, peoples dependence on computers and mobile phones is increasing day by day. This causes people to often overuse. Therefore, the incidence of Ocular muscle spasm has been increasing year by year in recent years. The disease usually starts and hides, which seriously affects the patients social image, daily life, and work.

METHODS/DESIGN

We will compare the clinical efficacy of thunder-fire moxibustion combined with acupressure with pure thunder-fire moxibustion on Ocular muscle spasm using random control method.

DISCUSSION

We aim to find a simple, safe, simple and effective Chinese medicine nursing technology that relieves Ocular muscle spasm.

TRIAL REGISTRATION

ClinicalTrials.gov,ChiCTR2000034187, Registered on 27 June 2020.

Secondary blepharospasm associated with structural lesions of the brain

BACKGROUND

Blepharospasm is a form of focal dystonia that manifests as repetitive involuntary closure of the eyes. The pathogenesis of blepharospasm and the neuroanatomic substrates involved are not fully understood. Dysfunction of the basal ganglia traditionally is presumed to be the main cause of most forms of dystonia, but a growing body of evidence suggests that a network of additional cortical and subcortical structures may be involved.

METHODS

The medical records of 1114 patients with blepharospasm seen over past 10 years at Emory University were reviewed to identify potentially contributing brain lesions. A systematic review of the published literature was also conducted to identify potentially contributing brain lesions.

RESULTS

Among patients with blepharospasm at Emory University, 18 had focal lesions on imaging studies available for review. The literature review revealed 25 articles describing 30 additional cases of blepharospasm associated with focal lesions. Among all 48 cases, lesions were found in multiple regions including the thalamus (n=12), lower brainstem (n=11), basal ganglia (n=9), cerebellum (n=9), midbrain (n=7), and cortex (n=1).

CONCLUSIONS

These data in combination with functional imaging studies of primary blepharospasm support a model in which a network of different regions plays a role in the pathogenesis of blepharospasm.

Clozapine for blepharospasm, obsessive-compulsive symptoms, and psychotic symptoms in a patient of old brain infarction

Blepharospasm, psychotic symptoms, and obsessive-compulsive symptoms can result from brain infarction. However, a presentation of these 3 symptoms simultaneously is rare. This report describes a 65-year-old woman who had old brain infarction and presented with these 3 symptoms for 2 years. The patient recovered after receiving a regimen of clozapine 125 mg/d for 3 months. No recurrences of symptoms were noted during a 6-month follow-up. This is the first case report demonstrating that clozapine is effective for a patient with blepharospasm, obsessive-compulsive symptoms, and psychotic symptoms presenting simultaneously. This report also reminds physicians of the possible organic causes of unusual presentations in elderly patients.

Transient blepharospasm secondary to unilateral striatal infarction

We report on a patient who presented a transient eyelid motor disorder characterized by bilateral reflex blepharospasm as the main clinical manifestation of a right-sided striatal infarction. This case emphasizes the role of the nondominant striatum in the pathophysiology of eyelid motor abnormalities.

Positron emission tomography scanning in essential blepharospasm

PURPOSE

To localize in the brain using positron emission tomography neuroimaging with (18)fluorodeoxyglucose [PET ((18)FDG)] differences in glucose metabolism between patients with essential blepharospasm (EB) and controls.

DESIGN

Prospective case-control study.

METHODS

Positron emission tomography neuroimaging with (18)fluorodeoxyglucose was performed in 11 patients with EB and 11 controls matched for age and gender. Global analysis of images was used to localize differences in glucose metabolism between groups.

RESULTS

Multiple cortical and subcortical abnormalities were observed in EB patients in comparison with controls. Cortical areas with the largest and most significant clusters of increased glucose uptake were the inferior frontal gyri, right posterior cingulate gyrus, left middle occipital gyrus, fusiform gyrus of the right temporal lobe, and left anterior cingulate gyrus. Cortical areas with the largest and most significant clusters of decreased glucose uptake were the inferior frontal gyri, ventral to the area of increased glucose metabolism. Subcortical abnormalities, consisting of increased glucose uptake, involved the right caudate and consisting of decreased glucose uptake, involved the left inferior cerebellar hemisphere and thalamus.

CONCLUSIONS

Global analysis of positron emission tomography neuroimaging with (18)fluorodeoxyglucose neuroimaging in EB patients in comparison with controls demonstrates a pattern of abnormalities involving several cortical and subcortical areas that control blinking, including the inferior frontal lobe, caudate, thalamus, and cerebellum.