Botulinum toxin for blepharospasm: challenges for rehabilitation nurses.

Blepharospasm is a chronic, progressive, involuntary spasmodic closure of the eyelids associated with abnormal facial and oromandibular movements. It is a neurologic disorder whose cause is unknown and whose pathophysiology is poorly understood. Without appropriate treatment, it can result in functional blindness and other disabilities. In the last decade, botulinum toxin has been found to be effective therapy for most individuals. The drug, which is given by local injection, has a denervation effect. It relieves symptoms for several months, allowing patients to resume their former lifestyles between treatments. This new therapy modality challenges rehabilitation nurses to bridge the gap between disabled persons in the community and this new technology. Casefinding, referrals, and patient education are among the interventions that can help meet this challenge. The major purpose of this article is to inform rehabilitation nurses about how to recognize the symptoms of neurologic blepharospasm and how to intervene to prevent disabilities that could result.