A scoping review about the efficacy of clonazepam for the treatment of benign essential blepharospasm.

BACKGROUND

Benign Essential Blepharospasm (BEB) is a focal dystonia that leads to an increased rate of eyelid closure due to involuntary activation of the orbicularis oculi muscles. In severe cases, daily activities can significantly be affected, with reduced quality of life. Injections of OnabotulinumtoxinA are often used as valid therapeutical option. However, this treatment may not be tolerated by all patients, considering its invasive nature and the need for access to specialized centers. Despite oral agents, such as benzodiazepines (particularly clonazepam), are often used as a first-line treatment, evidence regarding their efficacy remains fragmentary.

OBJECTIVE

This scoping review aims to evaluate the current evidence for the efficacy of clonazepam for benign essential blepharospasm.

METHODS

Articles in English about the use of clonazepam in the treatment of BEB were searched for in three major databases (PubMed, Scopus, Cochrane).

RESULTS

The search yielded 259 results. After screening, 13 papers were sought for retrieval. After assessing their suitability, 2 articles were included in the review: one open-label trial and one case report. Despite some limitations, both showed the effectiveness of clonazepam in BEB.

CONCLUSION

Although some evidence supports the use of clonazepam in the treatment of BEB, high-quality studies are still needed to clarify aspects such as response rates, optimal dose, and other disease management issues. This information may be useful for clinicians who are unable to refer their patients to specialized centers and must rely on their own experience and anecdotal evidence for patient management.