Grandas F, Elston J, Quinn N, Marsden C D
University Department of Neurology, Institute of Psychiatry, London, UK.
J Neurol Neurosurg Psychiatry. 1988 Jun;51(6):767-72. doi: 10.1136/jnnp.51.6.767.
The natural history and response to different treatments have been evaluated in 264 patients with blepharospasm. The mean age of onset was 55.8 years and there was a female preponderance of 1.8 to 1. Dystonia elsewhere was found in 78% of patients, usually in the cranial-cervical region, and appeared to follow a somatotopic progression. A family history of blepharospasm or dystonia elsewhere was found in 9.5% of cases, which suggests a genetic predisposition. Ocular lesions preceded the onset of blepharospasm in 12.1% of cases. The response to drugs was inconsistent, although initial improvement was experienced by one fifth of patients treated with anticholinergics. Twenty-nine bilateral facial nerve avulsion operations were performed with benefit in 27 cases; but recurrences appeared in 22, on average one year after surgery. Botulinum toxin injections were performed in 151 patients. Significant improvement was achieved in 118 cases. Mean duration of benefit was 9.2 weeks. Transient ptosis and diplopia were the commonest side effects.
对264例睑痉挛患者的自然病史及不同治疗方法的反应进行了评估。发病的平均年龄为55.8岁，女性占优势，男女比例为1.8比1。78%的患者在其他部位存在肌张力障碍，通常在颅颈区域，且似乎呈躯体定位进展。9.5%的病例有睑痉挛或其他部位肌张力障碍的家族史，这提示存在遗传易感性。12.1%的病例在睑痉挛发作前有眼部病变。药物治疗的反应不一致，尽管接受抗胆碱能药物治疗的患者中有五分之一最初有改善。实施了29例双侧面神经撕脱术，27例有效；但22例复发，平均在术后一年复发。151例患者接受了肉毒杆菌毒素注射。118例取得显著改善。获益的平均持续时间为9.2周。短暂性上睑下垂和复视是最常见的副作用。
