1/10. Orbicularis myectomy with levator advancement in Schwartz-Jampel syndrome.PURPOSE: Schwartz-Jampel syndrome is a disorder of continuous myotonia causing blepharospasm, acquired ptosis, and blepharophimosis. We report the management of the associated eyelid anomalies with orbicularis oculi myectomy, levator aponeurosis resection, and lateral canthopexy. methods: Interventional case reports. Two patients with Schwartz-Jampel syndrome presented with blepharospasm, acquired ptosis, and blepharophimosis. Orbicularis myectomy, levator aponeurosis resection, and lateral canthopexy were performed to relieve the blepharospasm and to correct the ptosis and blepharophimosis. RESULTS: Significant functional and cosmetic improvements were achieved by increasing the palpebral fissure height and length while greatly decreasing the blepharospasm of the patients. No recurrence of the blepharospasm or eyelid anomalies has been noted after 1 and 15 years of follow-up, respectively. CONCLUSION: The blepharospasm and eyelid alterations caused by Schwartz-Jampel syndrome should be treated to provide functional and cosmetic improvements. Our technique of myectomy, levator resection, and lateral canthopexy provides an excellent, long-lasting result.- - - - - - - - - - ranking = 1keywords = blepharospasm (Clic here for more details about this article) |
2/10. Schwartz-Jampel syndrome: surgical management of the myotonia-induced blepharospasm and acquired ptosis after failure with botulinum toxin A injections.A 6-year-old boy with Schwartz-Jampel syndrome and severe myotonia-induced blepharospasm and ptosis did not respond to botulinum toxin A injections in the orbicularis muscle. The clinical diagnosis was further supported by electromyography. Surgical management using a combination of techniques in one operation produced a satisfactory result for both function and appearance. Muscle biopsy was also done during surgery.- - - - - - - - - - ranking = 0.83333333333333keywords = blepharospasm (Clic here for more details about this article) |
3/10. A case of bilateral ptosis associated with cerebral hemispheric lesions.Ptosis occurs in a variety of disorders including myasthenia gravis, oculomotor palsy, Horner's syndrome and brain stem disorders. There are also supranuclear lesions causing blepharoptosis. The latter disorders are reflex blepharospasm, apraxia of eyelid opening and Meige's syndrome. Since the total number of bilateral ptosis associated with cerebral hemispheric lesions is very few, whether the responsible lesions are located in the nondominant hemisphere or bilateral hemispheres are still controversial. We report here a case of bilateral cerebral ptosis that occurred in association with cerebral infarction of the nondominant hemisphere.- - - - - - - - - - ranking = 0.16666666666667keywords = blepharospasm (Clic here for more details about this article) |
4/10. Coexistent Meige's syndrome and myasthenia gravis. A relationship between blinking and extraocular muscle fatigue?We studied five patients with a combination of Meige's syndrome (blepharospasm-oromandibular dystonia) and myasthenia gravis. The coexistence of two disorders impairing eyelid opening led to diagnostic confusion and delayed appropriate therapy. Detailed oculographic monitoring of one patient indicated that eye position drifting due to myasthenic oculomotor fatigue was corrected by eye blinks, and that blinks tended to occur with slower saccades. Our observations suggest that fatigue of extraocular muscles may lead to synkinetic blinking and perhaps eventually to autonomous blepharospasm.- - - - - - - - - - ranking = 0.33333333333333keywords = blepharospasm (Clic here for more details about this article) |
5/10. Botulinum toxin for the treatment of essential blepharospasm.Twenty-six patients with essential blepharospasm were treated with botulinum toxin by injection. The onset of protractor weakness in all patients ranged from one to five days following treatment. Maximal weakness developed within 12 days. There was a variable and gradual return of protractor strength over eight to 29 weeks in most patients and, with it, a return of spasm. Twenty-five patients received some degree of functional relief following initial injection. In most patients, however, the post-injection result could not be stabilized and repeat injections have been necessary to control recurrent spasms. There was one treatment failure. Three patients treated by injection following previous neurectomy and myectomy appeared to have a reduced requirement for subsequent injections. Complications included transient ptosis in six patients and mild exposure symptoms in four patients. Extraocular muscle paresis did not occur. There were no systemic side effects from the botulinum toxin injections.- - - - - - - - - - ranking = 0.83333333333333keywords = blepharospasm (Clic here for more details about this article) |
6/10. Ptosis associated with botulinum toxin treatment of strabismus and blepharospasm.The incidence, severity, and duration of ptosis after botulinum neurotoxin type A (BAT) injections into extraocular or orbicularis muscles were reviewed retrospectively. Even though lid droop frequently complicated botulinum toxin treatment in this series, no loss of vision or permanent ptosis was encountered. Sixty-seven injections were completed in 44 patients between September 1982 and December 1983. The records were reviewed to determine the incidence of ptosis after these 67 injections. Information was not adequate to ascertain the presence or absence of ptosis after 10 injections. Some degree of ptosis developed after 30 (53%) of the 57 injections with adequate follow-up history. Marked ptosis occurred after 12 (21%) of the 57 injections. The posttreatment lid droop in these 12 cases was potentially visually significant. All cases of ptosis, which impinged on the visual axis, resolved to a level permitting undisturbed vision by eight weeks after toxin injection. The incidence of ptosis was similar in patients who received injections into their medial rectus muscles and in patients who received injections into their lateral rectus muscles. However, an increased incidence of marked ptosis may be associated with the injection of previously operated muscles. Toxin dosage, patient age, and quality of the electromyogram used to monitor the injection showed no statistically significant relationship to the ptosis.- - - - - - - - - - ranking = 0.66666666666667keywords = blepharospasm (Clic here for more details about this article) |
7/10. Prosthesis for blepharoptosis and blepharospasm.blepharoptosis and blepharospasm are ocular phenomena, which cause severe functional and cosmetic problems. Both conditions respond poorly to medical and surgical correction, although surgery does provide a moderate degree of success in ptosis cases. Ptosis prostheses (crutches) have been utilized for years with only limited degrees of success. It is the author's opinion that this has been due to a lack of scientific approach to the design and limitations of the materials available for the device. To eliminate these problems, we devised and organized an approach to the design of the prosthetic device and utilized new materials with advantageous characteristics for the crutch. The results have been remarkable from a cosmetic and functional aspect and have produced an improvement in a condition considered beyond the pale of relief or treatment.- - - - - - - - - - ranking = 0.83333333333333keywords = blepharospasm (Clic here for more details about this article) |
8/10. Levator aponeurosis dehiscence in a patient treated with botulinum toxin for blepharospasms and eyelid apraxia.A 63 years old woman presented with bilateral blepharospasms and eyelid apraxia which was treated with Botulinum toxin injections. A post-treatment ptosis was seen with preserved levator function. It was then suggested that manual eyelid traction could have caused aponeurotic dehiscence of the levator muscles. Surgical exploration confirmed this diagnosis. One must be aware that eyelid apraxia can mask an aponeurotic dehiscence of the levator muscle induced by chronic manual traction exerted on the apractic eyelids.- - - - - - - - - - ranking = 0.83333333333333keywords = blepharospasm (Clic here for more details about this article) |
9/10. Acquired blepharoptosis secondary to essential blepharospasm.We treated four patients with essential blepharospasm, receiving botulinum A toxin, in whom, although they had no preexisting blepharoptosis, a concurrent bilateral acquired blepharoptosis developed. Since the blepharoptosis did not improve after the period of time during which the effects of botulinum A toxin would have been expected to resolve (2 to 10 weeks), we judged that its development was unrelated to the toxin. We propose, rather, that the stretching, attenuation, disinsertion, or dehiscence of the upper eyelid levator muscle caused by the blepharospasm were at least partly responsible for the onset of the blepharoptosis. To ensure appropriate treatment in these cases, careful clinical evaluation is required to differentiate the two conditions.- - - - - - - - - - ranking = 1keywords = blepharospasm (Clic here for more details about this article) |
10/10. Levator aponeurosis surgery in Schwartz-Jampel syndrome.Schwartz-Jampel syndrome is a rare disorder with prominent palpebral fissure changes. These changes are complex and have been described as ptosis, blepharophimosis, and blepharospasm. Two new cases of the Schwartz-Jampel syndrome and the results of elevating the upper eyelid margin with levator aponeurosis surgery are presented, along with a review of the literature.- - - - - - - - - - ranking = 0.16666666666667keywords = blepharospasm (Clic here for more details about this article) |
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