Botulinum Toxin Treatment in Blepharospasm: Single-center Experience

Objective: Blepharospasm (BS) is a focal dystonia that affects periocular muscles such as the orbicularis oculi, procerus, and corrugator. The disease may occur in isolation or in the course of neurodegenerative diseases, and its first-line treatment is the administration of botulinum toxin. In this study, we aim to analyze the clinical features of patients with BS.
Materials and Methods: In this study, the clinical features and treatment responses of patients with BS were retrospectively analyzed.
Results: Of the 49 patients included in the study, 23 were female and 26 were male. The mean age at administration was 56.8 ± 10.8 (between 35 and 85 years), and the mean age of onset was 52.2 ± 11.9 (between 21 and 82 years). Fourteen patients had a diagnosis of a neurodegenerative disease. Fourteen patients had additional oral treatment for their symptoms. The most common oral treatments were anticholinergic drugs, benzodiazepines, and antiepileptics. The mean unit of botulinum toxin was 32.4 ± 5.8 (15.0–42.5). Treatment response was evaluated in 42 patients. Of these, 36 (86%) had either good or excellent benefit. The mean duration of treatment benefit was 105.35 ± 36.35 (between 30 and 180) days. Pretarsal application was associated with better and more prolonged treatment response than preseptal. Other analyzed clinical parameters showed no effect on the benefit of botulinum toxin. Side effects were observed in seven patients, and the most common were orbicularis oculi weakness, ecchymosis, and xerophthalmia.
Conclusion: Our study demonstrated that botulinum toxin is effective and safe in the treatment of BS. Although pretarsal application has a similar side-effect profile to preseptal application, it was associated with better and longer treatment benefit.