Purchase this article with an account.
L. N. Johnson, R. W. Lapour, G. M. Johnson, P. J. Johnson, R. W. Madsen, S. A. Hackley; Stressful Life Events, Complicated Grief, and Depression in the Pathogenesis of Essential Blepharospasm and Hemifacial Spasm: The Double-Hit Hypothesis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5287.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Essential blepharospasm and hemifacial spasm are debilitating dystonias that render the affected individual functionally blind. Current treatments, such as with botulinum toxin injections, result in only temporary relief of the facial spasm. If major lifetime stress resulting in complicated grief and depression is found to be contributory, this could lead to early detection and therapeutic strategies for a more permanent cure. The study assesses the role of major stressful life events, complicated grief, and depression in the pathogenesis of essential blepharospasm (EB) and hemifacial spasm (HFS).
Case-control study comparing the rate of major stressful life events ("hits"), depression on the Beck Depression Inventory, and complicated grief on the Inventory of Complicated Grief between 23 EB/HFS participants and 23 controls.
Of the 46 subjects, 24 (52%) had depression and 8 (17%) had complicated grief. EB/HFS participants experienced a shorter time interval between 2 major lifetime hits (P=0.0048) than the control group (EB/HFS, median 4 months; controls, median 3.0 years). Facial spasms began within 1 year of a major hit for 70% of EB/HFS participants. The proportion of participants who suffered a "double hit" (i.e., 2 major stressful lifetime events separated by 1 year or less) was significantly greater for EB/HFS participants than controls (P = 0.0007).
In many cases, the onset of EB and HFS begins shortly after a major lifetime stressor. Subjects who sustain an emotional double hit are at increased risk of developing EB and HFS.
This PDF is available to Subscribers Only