title: Pretarsal application of botulinum toxin for treatment of blepharospasm.
abstract: The response to botulinum toxin type A was compared after two injection techniques in 45 patients with blepharospasm. Initially, patients were treated according to a triple injection technique; two injections into the upper eyelid and one injection into the lower eyelid. Subsequently, without altering the dose, the same patient group received two further injections into the pretarsal portion of the orbicularis oculi muscle of the upper lid. Triple injections were given in 227 treatments, of which 81% were successful. Mean duration of benefit was 8.5 weeks. Additional pretarsal injections were given in 183 treatment sessions. The number of successful treatments significantly increased, to 95% (P < 0.001), and the mean duration of benefit increased to 12.5 weeks (P < 0.001). Ptosis occurred significantly less often after pretarsal injections (P < 0.01). Patients with combined blepharospasm and involuntary levator palpebrae inhibition responded better to the pretarsal injection technique.
authors.affiliation: Department of Neurology, Graduate School Neurosciences Amsterdam, AZUA, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Aramideh
authors.forename: B W
authors.initials: BW
authors.lastname: Ongerboer de Visser
authors.forename: J W
authors.initials: JW
authors.lastname: Brans
authors.forename: J H
authors.initials: JH
authors.lastname: Koelman
authors.forename: J D
authors.initials: JD
authors.lastname: Speelman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000503:physiopathology / Q000628:therapy*; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D004576:Electromyography; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000187:drug effects / Q000503:physiopathology
chemical_list: D001905:Botulinum Toxins