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D.S. Bardenstein, R.L. Tomsak; Low level cryotherapy (LLCT) in the Management of Benign Essential Blepharospasm (BEB) . Invest. Ophthalmol. Vis. Sci. 2004;45(13):260.
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Purpose:To share clinical and experimental data regarding a new method for the management of BEB Methods: Clinical– A patient who clinically had BEB and dry eyes manifested by frequent blinking and intermittent eyelid spasm disabling her from driving and working, refused standard treatment modalities. Application of a cold pack to the lids for 10 minutes caused profound reduction in manifestations. She was begun on a trial of ice pack treatments 4 times daily in addition to artificial tears. Failure to maintain a regular treatment regimen led to recurrence of BEB symptoms. Experimental: Several types of subjects; normal adults, BEB patients and thyroid associated orbitopathy (TAO) patients with lid retraction and frequent blinking underwent quantitation of blink rates before and after a 10 minute application of a cold pack to the lids. Results: Clinical– This use of LLCT, led to complete control of her blepharospasm over a period of 2 years. She had neither side effects nor progression of her BEB. Experimental–BEB patients showed decreases in blink rate of 50–66%, TAO patients showed decreases of less than 10 %, as did normals. Conclusions: BEB is a disabling condition whose etiology is unclear. Other disorders of neuromuscular function in the eyelid, such as myasthenia gravis, have shown response to cryotherapy as a diagnostic tool. In selected patients, LLCT appears to provide excellent relief in a completely safe and low cost manner. The apparent selective effect of LLCT on this modality compared to another entity with frequent blinking whose etiology is felt to be structural, suggests a probable role for local neuromuscular abnormalities in its etiology.
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