Use of onabotulinum toxin a in the management of benign essential blepharospasm: a case report
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20262850Keywords:
Benign essential blepharospasm, Onabotulinum toxin A, Botulinum toxin, Focal dystoniaAbstract
Benign essential blepharospasm (BEB) is a focal cranial dystonia characterized by involuntary eyelid contractions that may lead to marked visual and functional disability. Botulinum toxin type A (BotnA) is considered the treatment of choice for symptomatic relief. We describe a case of a 40-year-old male with BEB who showed significant clinical improvement following treatment with onabotulinum toxin A, emphasizing its efficacy and safety profile. In our case, botulinum toxin A was injected at specific points in orbicularis oculi muscle (affected side), corrugator supercilli, procerus, frontalis (forehead). Relief from symptoms was achieved after 5 to 7 days. No side effects were noted. After day 15, complete resolution of symptoms was achieved, effect was maintained till 6 months. BotnA is a minimally invasive and safe procedure for management of BEB. It can be easily performed in minutes in OPD set up under sterile environment.
References
Jankovic J. Treatment of dystonia. Lancet Neurol. 2006;5(10):864-72. DOI: https://doi.org/10.1016/S1474-4422(06)70574-9
Hallett M. Blepharospasm: recent advances. Neurology. 2002;59(9):1306-12. DOI: https://doi.org/10.1212/01.WNL.0000027361.73814.0E
Jankovic J, Orman J. Botulinum A toxin for cranial-cervical dystonia: a double-blind placebo-controlled study. Neurology. 1987;37(4):616-23. DOI: https://doi.org/10.1212/WNL.37.4.616
Defazio G, Hallett M, Jinnah HA, Berardelli A. Blepharospasm 40 years later. Mov Disord. 2017;32(4):498-509. DOI: https://doi.org/10.1002/mds.26934
Defazio G, Abbruzzese G, Girlanda P. Blepharospasm and associated symptoms. Mov Disord. 2015;30(5):727-34.
Jinnah HA, Factor SA. Diagnosis and treatment of dystonia. Neurol Clin. 2015;33(1):77-100. DOI: https://doi.org/10.1016/j.ncl.2014.09.002
Simpson DM, Hallett M, Ashman EJ. Practice guideline update summary: Botulinum neurotoxin for the treatment of movement disorders. Neurology. 2016;86(19):1818-26. DOI: https://doi.org/10.1212/WNL.0000000000002560
Albanese A, Barnes MP, Bhatia KP. A systematic review on the clinical use of botulinum toxin in movement disorders. Eur J Neurol. 2006;13(4):1-9.
Aoki KR. Pharmacology and immunology of botulinum toxin type A. Clin Dermatol. 2003;21(6):476-80. DOI: https://doi.org/10.1016/j.clindermatol.2003.11.006
Truong D, Dressler D, Hallett M. Manual of Botulinum Toxin Therapy. 2nd ed. Cambridge University Press. 2014. DOI: https://doi.org/10.1017/CBO9781139178068
Steeves TD, Day L, Dykeman J. The prevalence of primary dystonia: a systematic review and meta-analysis. Mov Disord. 2012;27(14):1789-96. DOI: https://doi.org/10.1002/mds.25244
Anderson RL, Patel BC, Holds JB, Jordan DR. Blepharospasm: past, present and future. Ophthalmic Plast Reconstr Surg. 1998;14(5):305-17. DOI: https://doi.org/10.1097/00002341-199809000-00002
Costa J, Espírito-Santo C, Borges A. Botulinum toxin type A therapy for blepharospasm. Cochrane Database Syst Rev. 2005;(1):CD004900. DOI: https://doi.org/10.1002/14651858.CD004899.pub2
Lee MS, Hwang JM, Kim JS. Comparison of pretarsal and preseptal botulinum toxin injection in blepharospasm. Ophthalmology. 2006;113(5):819-823.
Naumann M, Jankovic J. Safety of botulinum toxin type A: a systematic review and meta-analysis. Curr Med Res Opin. 2004;20(7):981-90. DOI: https://doi.org/10.1185/030079904125003962