title: Demographic and clinical features of patients with blepharospasm in southern Taiwan: a university hospital-based study.
abstract: OBJECTIVE
  Blepharospasm is a common focal dystonia. Severe blepharospasm has a disabling impact on work and everyday activities and may cause social embarrassment and catastrophic traffic accidents.This retrospective case-series study explored the demographic and clinical features and also the impact of blepharospasm on patients in southern Taiwan, where the climate is hot and humid and motorcycles are a popular mode of transportation.
  
  
  METHODS
  One hundred eleven patients with essential blepharospasm who had been given botulinum toxin type A injections at a university hospital were enrolled. Data were collected from medical records and face-to-face interviews with the patients and their families.
  
  
  RESULTS
  The mean age of onset was 58 years. The female/male ratio was 2.6: 1. Eighty-one percent of our patients had seen an ophthalmologist at the beginning of their condition. Photophobia, sleep benefit,and diurnal change of clinical symptoms were present in over 80% of the patients. The initial diagnostic accuracy was 37% for ophthalmologists and 44% for neurologists. Myasthenia gravis caused most confusion in the differential diagnosis. Eighteen percent of the patients had been involved in motorcycle and car accidents. Regular botulinum toxin type A injections improved both eyelid spasm and subjective ocular symptoms in most patients.
  
  
  CONCLUSIONS
  Blepharospasm is under-recognized, and its differentiation from myasthenia gravis needs to be improved. Patients with blepharospasm are advised to receive regular botulinum toxin type A injections and to avoid riding motorcycles and driving cars.
authors.affiliation: Department of Neurology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan. wjhwang@mail.ncku.edu.tw
authors.forename: Wen-Juh
authors.initials: WJ
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001764:Blepharospasm / Q000188:drug therapy* / Q000453:epidemiology*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D018575:Home Care Services, Hospital-Based; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A