Demographic and clinical features of patients with blepharospasm in southern Taiwan: a university hospital-based study.

PURPOSE: Blepharospasm is a common focal dystonia. Severe blepharospasm has a disabling impact on work and everyday activities and may cause social embarrassment and catastrophic traffic accidents.This retrospective case-series study explored the demographic and clinical features and also the impact of blepharospasm on patients in southern Taiwan, where the climate is hot and humid and motorcycles are a popular mode of transportation.

METHODS

One hundred eleven patients with essential blepharospasm who had been given botulinum toxin type A injections at a university hospital were enrolled. Data were collected from medical records and face-to-face interviews with the patients and their families.

RESULTS

The mean age of onset was 58 years. The female/male ratio was 2.6: 1. Eighty-one percent of our patients had seen an ophthalmologist at the beginning of their condition. Photophobia, sleep benefit,and diurnal change of clinical symptoms were present in over 80% of the patients. The initial diagnostic accuracy was 37% for ophthalmologists and 44% for neurologists. Myasthenia gravis caused most confusion in the differential diagnosis. Eighteen percent of the patients had been involved in motorcycle and car accidents. Regular botulinum toxin type A injections improved both eyelid spasm and subjective ocular symptoms in most patients.

CONCLUSION

Blepharospasm is under-recognized, and its differentiation from myasthenia gravis needs to be improved. Patients with blepharospasm are advised to receive regular botulinum toxin type A injections and to avoid riding motorcycles and driving cars.