Anderson R L, Patel B C, Holds J B, Jordan D R
Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City 84102, USA.
Ophthalmic Plast Reconstr Surg. 1998 Sep;14(5):305-17.
To investigate causes, associations, and results of treatment with blepharospasm, 1,653 patients were evaluated by extensive questionnaires to study blepharospasm and long-term results of treatment with the full myectomy operation, botulinum-A toxin, drug therapy, and help from the Benign Essential Blepharospasm Research Foundation (BEBRF). The percent of patients improved by the BEBRF was 90%, full myectomy 88%, botulinum-A toxin 86%, and drug therapy 43%. The patient acceptance rate for the BEBRF was 96%, full myectomy 82%, botulinum-A toxin 95%, and drug therapy 57%. Blepharospasm is multifactorial in origin and manifestation. A vicious cycle and defective circuit theory to explain in origin and direct treatment rather than a defective specific locus is presented. All four forms of therapy evaluated are useful and must be tailored to the patient's needs. Mattie Lou Koster and the BEBRF have helped blepharospasm sufferers more than any other modality, and all patients should be informed of this support group. The full myectomy is reserved for botulinum-A toxin failures, and the limited myectomy is an excellent adjunct to botulinum-A toxin.
为了调查眼睑痉挛的病因、关联因素及治疗结果，我们通过广泛的问卷调查对1653例患者进行了评估，以研究眼睑痉挛及全肌切除术、A型肉毒毒素、药物治疗以及来自良性原发性眼睑痉挛研究基金会（BEBRF）的帮助等治疗方法的长期效果。经BEBRF治疗后病情改善的患者比例为90%，全肌切除术为88%，A型肉毒毒素为86%，药物治疗为43%。患者对BEBRF的接受率为96%，全肌切除术为82%，A型肉毒毒素为95%，药物治疗为57%。眼睑痉挛在病因和表现上是多因素的。本文提出了一种恶性循环和缺陷回路理论来解释其病因及直接治疗方法，而非特定缺陷位点理论。所评估的所有四种治疗方式均有用，且必须根据患者的需求进行调整。玛蒂·卢·科斯特和BEBRF对眼睑痉挛患者的帮助比任何其他治疗方式都要多，所有患者都应了解这个支持组织。全肌切除术适用于A型肉毒毒素治疗失败的患者，而有限肌切除术是A型肉毒毒素的一种极佳辅助治疗方法。
