Bodker F S, Olson J J, Putterman A M
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago 60612.
Ophthalmic Surg. 1993 Aug;24(8):546-50.
We treated four patients with essential blepharospasm, receiving botulinum A toxin, in whom, although they had no preexisting blepharoptosis, a concurrent bilateral acquired blepharoptosis developed. Since the blepharoptosis did not improve after the period of time during which the effects of botulinum A toxin would have been expected to resolve (2 to 10 weeks), we judged that its development was unrelated to the toxin. We propose, rather, that the stretching, attenuation, disinsertion, or dehiscence of the upper eyelid levator muscle caused by the blepharospasm were at least partly responsible for the onset of the blepharoptosis. To ensure appropriate treatment in these cases, careful clinical evaluation is required to differentiate the two conditions.
我们对4例接受A型肉毒杆菌毒素治疗的特发性睑痉挛患者进行了观察，这些患者之前并无上睑下垂，但在治疗过程中均并发了双侧后天性上睑下垂。由于在预期A型肉毒杆菌毒素作用消失的时间段（2至10周）后，上睑下垂并未改善，我们判断其发生与毒素无关。相反，我们认为睑痉挛导致的上睑提肌拉伸、变薄、附着处分离或裂开至少是上睑下垂发生的部分原因。为确保对这些病例进行恰当治疗，需要仔细的临床评估以鉴别这两种情况。
