title: Clinical features of patients with blepharospasm: a report of 240 patients.
abstract: OBJECTIVE
  To characterize patients with benign essential blepharospasm (BEB) by diagnosis, environmental risk factors, and family history.
  
  
  METHODS
  Two hundred and forty patients with BEB were evaluated through a clinical examination and questionnaire. The questionnaire reviewed personal medical history, demographic factors, risk factors for the development of blepharospasm and family history of dystonia and other neurological conditions.
  
  
  RESULTS
  Benign essential blepharospasm was more commonly found in women (2.8:1) and 93% of the patients were Caucasian. Fifty percent had pure BEB, 31% had BEB/Meige's syndrome, and 4% had BEB and eyelid opening apraxia (+/- Meige's syndrome). A minority of patients reported preceding photophobia (25%) or other eye conditions (22%). The majority were non-smokers, had no exposure to anti-emetic or antipsychotic agents, had a normal birth history, and had no history of head trauma. Seventy-two percent did report a stressful event immediately prior to the development of symptoms. Treatments reported included botulinum toxin (BoNT), oral medications, surgical procedures, and acupuncture. Thirty-two percent of patients reported a family history of focal dystonia, and BEB was the most commonly reported.
  
  
  CONCLUSIONS
  This study confirms previous reports of usual age, sex, caffeine and tobacco use, and family history in patients with blepharospasm. New findings include a report on occupation, lower reports of preceding eye conditions and photophobia, and higher reported stressful events. Further, this study shows a change in treatment with an increase in BoNT use and decrease in surgical procedures.
authors.affiliation: Department of Neurology, Neurology Specialists of Dallas, Dallas, TX 7523, USA. bethulrich@hotmail.com
authors.forename: E L
authors.initials: EL
authors.lastname: Peckham
authors.forename: G
authors.initials: G
authors.lastname: Lopez
authors.forename: E A
authors.initials: EA
authors.lastname: Shamim
authors.forename: S Pirio
authors.initials: SP
authors.lastname: Richardson
authors.forename: S
authors.initials: S
authors.lastname: Sanku
authors.forename: R
authors.initials: R
authors.lastname: Malkani
authors.forename: M
authors.initials: M
authors.lastname: Stacy
authors.forename: P
authors.initials: P
authors.lastname: Mahant
authors.forename: A
authors.initials: A
authors.lastname: Crawley
authors.forename: A
authors.initials: A
authors.lastname: Singleton
authors.forename: M
authors.initials: M
authors.lastname: Hallett
mesh_terms: D000328:Adult; D017668:Age of Onset; D001764:Blepharospasm / Q000150:complications; D020821:Dystonic Disorders / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D012307:Risk Factors