title: Relationship between eye symptoms and blepharospasm: a multicenter case-control study.
abstract: Although patients with primary blepharospasm (BSP) commonly report experiencing ocular symptoms before the onset of orbicular spasms, the precise frequency and pathogenic role of this subjective ocular discomfort are poorly understood. We conducted a multicenter case-control study to investigate symptoms related to disorders of the anterior segment of the eye, administering a questionnaire to 165 patients with BSP and 180 age- and gender-matched control patients with hemifacial spasm. On a validation sample, our questionnaire yielded high accuracy in detecting eye diseases (predominantly, dry eye syndrome) using detailed ophthalmological examination as the criterion. Logistic regression analysis indicated a significant association between ocular symptoms at disease onset and BSP. Ocular symptoms starting in the year preceding disease onset (short-latency symptoms) showed a stronger association with BSP than ocular symptoms occurring earlier in time (long-latency symptoms). The association was stronger when short-latency symptoms developed from 40 to 59 years of age, whereas this was not observed for long-latency symptoms. Our findings support the view that eye symptoms associated with BSP result from eye diseases and may be involved in the pathogenesis of BSP. The differential risk of developing BSP, based on age at onset of ocular symptoms, suggests that age and eye diseases may interact in giving rise to BSP.
authors.affiliation: Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Martino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Defazio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Alessio
authors.forename: Giovanni
authors.initials: G
authors.lastname: Abbruzzese
authors.forename: Paolo
authors.initials: P
authors.lastname: Girlanda
authors.forename: Michele
authors.initials: M
authors.lastname: Tinazzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fabbrini
authors.forename: Lucio
authors.initials: L
authors.lastname: Marinelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Majorana
authors.forename: Maria
authors.initials: M
authors.lastname: Buccafusca
authors.forename: Laura
authors.initials: L
authors.lastname: Vacca
authors.forename: Paolo
authors.initials: P
authors.lastname: Livrea
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
mesh_terms: D017668:Age of Onset; D000368:Aged; D001764:Blepharospasm / Q000503:physiopathology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D003710:Demography; D003941:Diagnostic Techniques, Ophthalmological; D005128:Eye Diseases / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000503:physiopathology*