Cases reported "Blepharospasm"

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11/38. Tardive eating dystonia.

    After cessation of long-term treatment with haloperidol, a 77-year-old man developed severe dyskinetic-dystonic movements involving mainly the tongue and associated also with oromandibular dystonia and blepharospasm that were manifested exclusively during the process of eating and that interfered with feeding. There were no spontaneous involuntary movements nor were they apparent during any other simple or complex activations of the orofacial musculature.
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ranking = 1
keywords = dystonia
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12/38. blepharospasm, hemifacial spasm and the nurse's role.

    blepharospasm and hemifacial spasm are involuntary movement disorders that affect the facial muscles. They are classified as cranial dystonias. Their cause is unknown and the underlying pathophysiology is poorly understood. Both dystonias are more common in women than in men. It is the middle-aged group that is most frequently affected. Because of their high visibility, these disorders may cause considerable distress and embarrassment. Affected persons are often mistakenly considered to have psychiatric problems. In addition, both dystonias may result in severe disability. For example, the person with untreated blepharospasm may experience social isolation and functional blindness. Recently, therapy in the form of botulinum toxin became available in larger centers. Repeated injections of the toxin usually relieves symptoms and enable patients to resume a former lifestyle. Neuroscience nurses who are knowledgeable about cranial dystonias and the resources that are currently available can retard progression of disability and help restore the individual's quality of life. Informed neuroscience nurses can also play an important role in case-finding, counselling and referral. Two examples are presented in order to highlight some of the complexities inherent in the diagnosis and treatment of each type of cranial dystonia and to further clarify the nurse's role. These examples are based on the personal and professional experience of the authors.
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keywords = dystonia
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13/38. Polyradiculoneuritis following botulinum toxin therapy.

    The development of guillain-barre syndrome is reported in a patient, who had previously received botulinum toxin type A injections into both orbicularis oculi muscles to treat idiopathic blepharospasm. The possibility of a causal relationship is discussed with consideration of the literature on adverse effects of vaccinations and of clostridium botulinum and its toxin.
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ranking = 9.4016800918584E-5
keywords = idiopathic
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14/38. A familial syndrome of dystonia, blepharospasm, and pigmentary retinopathy.

    We report the clinical and laboratory findings in 2 siblings with a syndrome of pigmentary retinopathy, blepharospasm, and dystonia. This entity most resembles Hallervorden-Spatz disease, but appears to be a distinct disorder without identifiable neuroimaging or biochemical abnormalities.
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ranking = 1
keywords = dystonia
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15/38. blepharospasm associated with olivopontocerebellar atrophy.

    We report two cases of cranial dystonia (blepharospasm) associated with olivopontocerebellar atrophy (OPCA). The pathophysiology of blepharospasm appears to involve an increased excitability of the interneurons of the blink and corneal reflexes. It is hypothesized that blepharospasm associated with OPCA might be due to rostral brainstem lesions disrupting central dopaminergic and cholinergic pathways, resulting in disinhibition of brainstem reflexes or denervation supersensitivity of the facial nuclear complex.
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ranking = 0.2
keywords = dystonia
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16/38. Use of botulinum toxin to treat blepharospasm in a 16-year-old with a dystonic syndrome.

    A 16-year-old boy with generalized dystonia had continuous, severe blepharospasm and facial grimacing. Local intradermal injections of botulinum A toxin greatly reduced the spasms and improved function. No side effects were observed. Local botulinum A toxin injections may be useful in the treatment of eyelid and facial spasms in patients with generalized dystonias.
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ranking = 0.4
keywords = dystonia
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17/38. blinking-blepharospasm after long-term neuroleptic treatment.

    A patient is described who developed frequent blinking and blepharospasm after long-term treatment with trifluoperazine, whose condition improved dramatically after the cessation of the drug. The implications of this for our understanding of the manifestations and natural course of the late-onset side-effects of neuroleptic drugs are discussed. This case further supports the role of dopaminergic mechanisms in the aetiology of Meige's syndrome, which has blepharospasm and oromandibular dystonia as its main manifestations.
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ranking = 0.2
keywords = dystonia
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18/38. Life-threatening cranial dystonia following trihexyphenidyl withdrawal.

    A 64-year-old woman with blepharospasm, sustained clenching of the jaw, antecollis, and a strained, high-pitched phonation continued chronic trihexyphenidyl therapy despite the lack of any obvious benefit. Abrupt, accidental withdrawal of trihexyphenidyl triggered severe exacerbation of the cranial dystonia associated with inspiratory stridor and acute respiratory difficulties, prompting emergency admission. On indirect laryngoscopy, hyperadduction of the vocal folds was not the cause of the upper airway obstruction. A more likely cause of the inspiratory obstruction appeared to be forward bending of the neck combined with mouth-clenching spasms. Reinstitution of intravenous anticholinergic medication provided relatively prompt relief. We caution against abrupt interruption of anticholinergics in patients with severe segmental cranial dystonia, even in those cases in which no benefit is apparent to observers.
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ranking = 1.2
keywords = dystonia
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19/38. Ipsilateral blepharospasm and contralateral hemidystonia and parkinsonism in a patient with a unilateral rostral brainstem-thalamic lesion: structural and functional abnormalities studied with CT, MRI, and PET scanning.

    A patient developed progressive right hemidystonia in childhood. Subsequently, left-sided blepharospasm, slurred and stuttering speech, and right-sided rigidity and bradykinesia, responsive to dopamine agonists, appeared. Investigation with computed tomography and magnetic resonance imaging (MRI) at age 43 years revealed a left-sided calcified rostral brainstem-thalamic lesion of uncertain aetiology. Although no structural lesion was seen in the striatal regions, L-[18F]-fluorodopa uptake was severely diminished in the left striatum but normal on the right. Dopamine receptor binding identified by [11C]-methylspiperone was in the normal range on both sides.
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ranking = 1
keywords = dystonia
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20/38. Pathological report of four patients presenting with cranial dystonias.

    Secondary dystonias and experimental models of dystonia suggest that mechanisms responsible for primary dystonias may lie in the basal ganglia or brainstem. A histological study has been done in three patients with cranial dystonia (blepharospasm with oromandibular dystonia in two, blepharospasm alone in one), and one patient with craniocervical dystonia (oromandibular dystonia with retrocollis). In the patient with blepharospasm alone, an angioma, 0.5 mm in diameter, was found in the dorsal pons at the site of the central tegmental tract, confirming that some patients presenting with primary dystonias may have longstanding lesions in the brainstem. In the three other cases, the striatum, pallidum, thalamus, and brainstem were examined and cell populations in the putamen, substantia nigra, and inferior olives were compared with age-matched controls, but no significant abnormality was found.
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ranking = 2.4
keywords = dystonia
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