Botulinum toxin improves the quality of life and reduces the intensification of depressive symptoms in patients with blepharospasm

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Abstract

Blepharospasm (BSP) is a focal dystonia that results in hyperactivity of orbicular muscles of eyes. These symptoms often result in decreased quality of life (QoL) and symptoms of depression. Botulinum toxin type A is the current first line therapy. The aim of the present study was to analyze the impact of botulinum toxin treatment on the QoL and depressive symptoms in patients with BSP. The QoL was evaluated by means of the Short Form 36 questionnaire. The degree of the intensity of depression was evaluated by means of the Montgomery-Äsberg Depression Rating Scale. Botulinum toxin treatment significantly improves the QoL and reduces the intensity of depressive symptoms in all our study patients with BSP.

Introduction

Blepharospasm (BSP) results in hyperactivity of orbicular muscles of eyes, leading to serious functional visual disorders, including blindness. The aetiology of BSP is unknown. Since the treatment with botulinum toxin type A (BTX-A) is considered to be the therapy of choice, we decided to determine how treatment with BTX-A influences the quality of life (QoL) and symptoms of depression in patients with BSP.

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Patients and methods

The study was reviewed by the local ethics committee and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. All persons gave their informed consent prior to their inclusion in the study. Thirty-three patients with BSP were enrolled into the study (see Table 1). The study population consisted of 8 men and 25 women. Of these, 20 had benign essential BSP and 13 had Meige's Syndrome with dominant symptoms of BSP. Twenty-three patients suffered from

Results

Data analysis (see Fig. 2 and Table 2) showed that following treatment, physical functioning increased by 24.29%, role physical increased by 84.74% and role emotional increased by 102.39%, social functioning increased by 43.15%, mental health increased by 34.3%, vitality increased by 42.02%, bodily pain decreased by 13.12% (without statistical significance), whereas general health improved by 24.77%. The evaluation of their health performed by the patients themselves increased twice, general

Discussion

BSP is characterized by intensified involuntary tightening and closure of the eyelids, which can considerably limit activities of daily living. However, studies indicate that patients often consider the concomitant depression and anxiety to be more upsetting than the BSP itself [4]. In the majority of patients, contractions of the eyelids occur involuntarily. They intensify when they are nervous and under stress. Functional visual disturbances result in the patients being dependant on others

Conclusions

Local injections with BTX-A improve the QoL and reduce the severity of depressive symptoms in patients with BSP.

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