Neurology, CHU Caremeau, place du Professeur-Debré, 30000 Nîmes, France.
Neurology, CHU Caremeau, place du Professeur-Debré, 30000 Nîmes, France.
Rev Neurol (Paris). 2017 Dec;173(10):645-649. doi: 10.1016/j.neurol.2017.05.006. Epub 2017 Jun 16.
Blepharospasm is a focal dystonia characterized by involuntary cocontraction of the eyelid protractors, causing spasmodic closure of the eyelids. Apraxia of eyelid opening is caused by an inability to initiate lid opening without paralytic abnormality. Some studies suggest that patients with either pure blepharospasm or blepharospasm associated with apraxia of eyelid opening are more prone to developing Parkinson's disease.
In our study, I-FP-CIT (DAT) SPECT was performed in 24 patients with either pure blepharospasm or blepharospasm associated with apraxia of eyelid opening and no signs of parkinsonism to identify dopaminergic dysfunction.
DAT-SPECT was abnormal in 11 (46%) cases (five patients with isolated blepharospasm and six patients with blepharospasm associated with apraxia of eyelid opening) whose mean disease duration was 11 years.
Our study revealed presynaptic dopaminergic dysfunction, as determined by I-FP-CIT or DAT-SPECT, in nearly half of our blepharospasm patients (with or without apraxia of eyelid opening). Thus, the presence of blepharospasm might be an early sign of a parkinsonian syndrome.
眼睑痉挛是一种以眼外肌不自觉收缩为特征的局灶性肌张力障碍，导致眼睑痉挛性闭合。眼睑运动不能是由于无法在没有瘫痪异常的情况下开始眼睑张开。一些研究表明，单纯眼睑痉挛或伴有眼睑运动不能的眼睑痉挛患者更容易发展为帕金森病。
在我们的研究中，对 24 例单纯眼睑痉挛或伴有眼睑运动不能的眼睑痉挛且无帕金森病迹象的患者进行 I-FP-CIT（DAT）SPECT，以确定多巴胺能功能障碍。
11 例（46%）患者的 DAT-SPECT 异常（5 例单纯眼睑痉挛和 6 例伴有眼睑运动不能的眼睑痉挛），平均病程为 11 年。
我们的研究表明，近一半的眼睑痉挛患者（伴有或不伴有眼睑运动不能）存在 I-FP-CIT 或 DAT-SPECT 确定的突触前多巴胺能功能障碍。因此，眼睑痉挛可能是帕金森综合征的早期征象。
