Smet H, De Wilde F, Tassignon M J
Department of Ophthalmology, University Hospital Antwerp, Belgium.
Bull Soc Belge Ophtalmol. 1994;254:85-8.
A frontalis suspension was carried out in a patient with an essential type of blepharospasm, characterized by difficulties in initiating the act of lid elevation, often referred to as the apractic form of blepharospasm or, as J. Elston proposed, the pretarsal blepharospasm. The patient tries to open the eyes by using the frontalis muscle or by manual traction. It is known than in this form of blepharospasm, insufficient results are seen after botulinum toxin infection. Proper examination of the skin crease of the upper eyelid and of the eyelid gives an idea of the insertion of the levator aponeurosis and of the levator muscle function. A desinsertion, due to frequent manual traction, may be found. In this case, reinsertion of the aponeurosis may relieve the symptoms. If no desinsertion is present a frontalis suspension, similar to those used in ptosis surgery, may give good results.
对一名患有原发性睑痉挛的患者进行了额肌悬吊术，其特征为起始提睑动作困难，常被称为失用型睑痉挛，或者如J. 埃尔斯顿所提出的，睑板前睑痉挛。患者试图通过使用额肌或手动牵拉来睁开眼睛。已知在这种形式的睑痉挛中，肉毒杆菌毒素注射后效果不佳。对上睑皮肤皱襞和眼睑进行适当检查，可以了解提上睑肌腱膜的附着情况和提上睑肌功能。可能会发现由于频繁手动牵拉导致的腱膜附着松解。在这种情况下，腱膜重新附着可能会缓解症状。如果没有附着松解，则类似于上睑下垂手术中使用的额肌悬吊术可能会取得良好效果。
