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E. Merce, G. Casse, J.-P. Adenis, J.-P. Sauvage, P.-Y. Robert; Assessment of Blepharospasm and Botulinum Toxin Effects Using Videonystagmography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):662.
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© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to study blinking parameters using a videonystagmography device, in order to determine objectively disability, and to assess the efficiency of botulinum toxin injection in patients with essential blepharospasm.
Blinking was studied using the features of pupillary occlusion (PO) as recorded on a videonystagmography device. In 23 patients presenting with essential blepharospasm, we studied the frequency, the percentage and the mean duration of PO, and the longest PO in a 5min test time. Patients were tested prior to botulinum toxin injection, and respectively 1 month and 3 months after injection. PO of less than 0.3 s and more than 0.3 s were studied apart.
At 1 month after injection, botulinum toxin significantly influenced PO higher than 0.3 s, both in frequency (9.6/min ± 8.2 on Day0 and 4.7/min ± 7.2 on Month1 (p=0.004)), and in mean duration (0.95 s ± 0,84 on Day0 and 0.58 s ± 0,34 on Month1 (p=0.03)). On the other hand we found no significant effect on PO of less than 0.3 s, both in frequency (32.4/min ± 28.4 on Day0 and 31.3/min ± 29.0 on Month1 (p=0.7)) and in mean duration (0.16 s ± 0.04 at Day0 and 0.15 s ± 0.03 at Month1 (p=0.4)). Botulinum toxin significantly influenced also the mean duration of the longest PO (6,44 s ± 9.4 on Day0 and 1.55 s ± 1.9 on Month1 (p=0.004)) as well as the percentage of PO (29,95% ± 24.6 on Day0 and 13.44% ± 11.1 on Month1 (p=0.003)).
PO can be used as the indirect sign of blinking. Videonystagmography provides a real-time result, and could be used to objectively evaluate the effect of botulinum toxin treatment in essential blepharospasm patients.
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