Figure 1
Systematic search process for patients with blepharospasm.
Table 1
Demographic and clinical characteristics of patients with blepharospasm with uncertain etiology.
| DEMOGRAPHIC FEATURES | |
|---|---|
| Number of patients | 57 |
| Age at blepharospasm diagnosis, mean (SD) | 63.0 (10.8) |
| Sex (F), n(%) | 41 (71.9%) |
| Duration of follow-up in years, median (range) | 9.0 (0.17–25.9) |
| CLINICAL FEATURES | |
| Orbicularis oculi spasms, n(%) | 57 (100%) |
| Increased blinking rate, n(%) | 55 (96.5%) |
| Sensory trick (geste antagoniste), n(%) | 7 (12.3%) |
| Pretarsal blepharospasm, n(%) | 4 (7.0%) |
| Spread of dystonia to other body regions, n(%) | |
| No spread (focal dystonia), n(%) | 31 (54.4%) |
| Spread, n(%) | 26 (45.6%) |
| Segmental, n(%) | 18/26 (69.2%) |
| Multifocal, n(%) | 7/26 (26.9%) |
| Generalized, n(%) | 1/26 (3.8%) |
| Unilateral/asymmetric onset of blepharospasm,n(%) | 8 (14.0%) |
| Acute/subacute onset of blepharospasm, n (%) | 2 (3.5%) |
| Other neurological features at the onset of blepharospasm, n (%) | 8 (14.0%) |
| Remission of blepharospasm, n(%) | 4 (7.0%) |
| BRAIN IMAGING | |
| Brain imaging with CT/MRI, n(%) | 39 (68.4%) |
| Focal brain lesions1, n (%) | 7/39 (17.9%) |
| Causal lesions, n (%) | 4/39 (10.3%) |
[i] 1Any focal brain lesions before the onset of blepharospasm.
Table 2
Clinical characteristics of patients with lesion-induced and idiopathic blepharospasm.
| LESION-INDUCED | IDIOPATHIC | P-VALUE | |
|---|---|---|---|
| N = 4 | N = 53 | ||
| Age at blepharospasm diagnosis, median (range) | 66.5 (65–71) | 64.0 (29–87) | 0.444 |
| Sex (F), n (%) | 3 (75%) | 38 (71.7%) | 1.000 |
| Brain imaging, n (%) | 4 (100%) | 35 (66%) | – |
| Orbicularis oculi spasms, n (%) | 4 (100%) | 53 (100%) | 1.000 |
| Increased blinking rate, n (%) | 4 (100%) | 51 (96.2%) | 1.000 |
| Sensory trick (geste antagoniste), n (%) | 0 (0%) | 7 (13.2%) | 1.000 |
| Pretarsal blepharospasm, n (%) | 0 (0%) | 4 (7.5%) | 1.000 |
| Spread of dystonia to other body regions, n (%) | 1 (25%) | 25 (47.2%) | 0.617 |
| Unilateral/asymmetric onset of blepharospasm, n (%) | 4 (100%) | 4 (7.5%) | <0.001 |
| Acute/subacute onset of blepharospasm, n (%) | 2 (50%) | 0 | 0.004 |
| Other neurological features at the onset of blepharospasm, n (%) | 4 (100%) | 4 (7.5%) | <0.001 |
| Remission of blepharospasm, n (%) | 2 (50%) | 2 (3.8%) | 0.021 |
Table 3
Imaging findings in patients with atypical and typical blepharospasm.
| ATYPICAL BLEPHAROSPASM1 | TYPICAL BLEPHAROSPASM1 | P-VALUE | |
|---|---|---|---|
| N = 10 | N = 47 | ||
| Brain imaging, n (%) | 10 (100%) | 29 (61.7%) | 0.022 |
| Focal brain lesions2, n (%) | 4 (40.0%) | 3 (10.3%) | 0.057 |
| Causal lesions, n (%) | 4 (40.0%) | 0 | 0.003 |
[i] 1Acute/subacute onset of blepharospasm and/or other neurological features at the onset of blepharospasm and/or complete remission of blepharospasm.
2Any focal brain lesions before the onset of blepharospasm.