The effect of bangerter occlusion foils on blepharospasm and hemifacial spasm in occlusion-positive and occlusion-negative patients.

OBJECTIVE

To test the hypothesis that occlusion-positive (OP) patients with blepharospasm (BEB) or hemifacial spasm (HFS) will benefit from a Bangerter occlusion foil (BOF), compared to occlusion-negative (ON) patients. OP/ON was based on immediate improvement in spasm with placement of a hand in front of either eye.

DESIGN

Prospective non-randomised single-centre pilot study.

PARTICIPANTS

Fifteen-patients (6 BEB, 9 HFS).

METHODS

Patients were identified as OP or ON and wore highest-density BOF tolerable over one spectacle lens for 1 month. Outcomes were assessed at 1 month.

MAIN OUTCOME MEASURES

Validated quality-of-life questionnaire (CDQ-24), scores of blink-rate and spasm severity assessed by two observers from video-recordings.

RESULTS

OP group had mean improvement in all scores. There was no change or worsening of scores in the ON group. In both BEB and HFS, more OP patients reported subjective benefit from wearing a foil (2 of 4 BEB, and 2 of 2 HFS) compared to the ON group (0 of 2 BEB, and 1 of 7 HFS).

CONCLUSION

OP patients with BEB and HFS are more likely to experience improvement in spasms from wearing a BOF compared to ON patients. The occlusion test should be considered on all patients with BEB or HFS.