جستجوی مقالات مرتبط با کلیدواژه « Blepharospasm » در نشریات گروه « پزشکی »

A 68- year – old male was admitted to ER of Referral Imam Khomeini hospital with abrupt commence of fever accompanied with debilitating non-radiating headache, photophobia, ataxia and cluster of confluent vesicles on right side of forehead with swelling of right eyelid. All his symptoms started after receiving Botulinum injection on the same week before admission and he had never had similar manifestations beforehand.His medical history was remarkable for hyperlipidemia, hypertension and right side Blepharospasm for which he received Botulinum injection every 6 months. He was on medication for the rest of his medical problems. He was not on any immunosuppressive medication and did not suffer from any disease weakening the immune system. His family history was unremarkable for any similar problems.In medical exam, he was ill but not toxic, his vital signs were blood pressure of 135/80 mmHg, heart rate of 76, respiratory rate of 17 and oral temperature of 38.5Ĉ. He had vesicles on his right forehead. Heart sounds were regular without murmur. Lungs were clear. Abdominal examinations were inconspicuous.In neurological examinations, he was confused and disoriented to time and place. Cranial nerves were without any pathological findings except for positive Marcus Gunn of affected side and blurring of right optic disk margin. No muscle atrophy was seen. Muscle force showed no weakness. He was ataxic. Sensory examination was normal. Reflexes were checked and were within normal limits and symmetric.Computer tomography (CT) scan of head was unremarkable and his MRI scan did not reveal any information compatible with his symptoms.Due to the sudden onset of fever with headache and confusion, encephalitis was suspected and empirical therapy with antibiotics was started and LP was performed which indicated pleocytosis in CSF. According to the vesicles on the skin and with suspicion of Varicella encephalitis, PCR was sent for diagnosis of VZV. Subsequently, his condition got dramatically better and symptoms diminished after acyclovir was started.

 The blink reflex recovery cycle indicates the excitability of interneurons in the brainstem. In this study, we aimed to investigate the blink reflex and R2 recovery cycle in patients with benign essential blepharospasm (BEB).

 This prospective case-control study compared the blink reflex and R2 recovery in 18 BEB patients with 18 age- and gender-matched healthy individuals. The blink reflex was measured in a stimulation duration of 0.2 ms, and R1, R2, and R2’ were recorded for all subjects. The R2 recovery cycle was measured by stimulation of the supraorbital nerve at four interstimulus intervals (ISI) of 200, 300, 500, and 1000 ms, with the same intensity as the previous test. The R2 recovery index was calculated and compared with the control group via independent sample t-test. Two-tailed P-value less than 0.05 was considered statistically significant.

 The blink reflex (R1, R2, and R2’ responses) distal latencies and amplitudes in the BEB group were not significantly different from the control group (P>0.05). The R2 recovery index in all intervals was significantly higher in the BEB group than the control group (P=0.00). The most significant difference between the BEB and control groups regarding the R2 recovery indices was observed at ISIs of 300 and 200 ms (80.36 vs. 16.99 and 75.70 vs. 12.57, respectively). There was a negative correlation between the patient’s age at the onset of disease and the R2 recovery index; however, it was not statistically significant (P>0.05).

 Our findings showed that the R2 recovery reflex was higher in BEB patients than the normal population. Therefore, it can be a helpful index for differentiating BEB cases from psychogenic or malingering ones.

The objective of this case report was to highlight one of the uncommon subtypes of tardive dyskinesia (TD) as tardive blepharospasm secondary to olanzapine.

We reported a rare case of young-onset schizophrenia in an adolescent patient, who was treated with olanzapine, but subsequently developed tardive blepharospasm. Clinical resolution of the blepharospasm after olanzapine was stopped and switched to quetiapine.

Tardive blepharospasm can be a regarded as a presentation of tardive dyskinesia. Complete recovery of the symptoms can be achieved by stopping the offending drug early and switching to a serotonin-dopamine receptor antagonist.

To describe a patient with Schwartz Jampel vel Aberfeld syndrome (SJS) who underwent orbicularis oculi myectomy as a treatment for blepharospasm.
Case Report: A 4‑year‑old child with SJS did not respond to an injection of a single dose of botulinumtoxin after one month, so orbicularis myectomy was then performed under general anesthesia. During the procedure, orbicularis vermiform movements were a useful guide for the extent of myectomy that the patient needed. He responded very well to this procedure and experienced significant relief of blepharospasm documented in follow‑up visits for up to 6 months.
Blepharospasm in patients with SJS can be treated with orbicularis oculi myectomy as a good functional method with faster and durable response in comparison to botulinum toxin injection.