scholarly journals Frequency of obsessive and compulsive symptoms in patients with blepharospasm and hemifacial spasm

2005 ◽  
Vol 63 (2a) ◽  
pp. 213-216 ◽  
Author(s):  
Renato P. Munhoz ◽  
Helio A.G. Teive ◽  
Marcus V. Della Coletta ◽  
Francisco M.B. Germiniani ◽  
Fábio M. Iwamoto ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Facial Nerve ◽  
Psychiatric Disorders ◽  
Hemifacial Spasm ◽  
Structured Interview ◽  
Test Results ◽  
Scale Scores ◽  
Dsm Iv ◽  
The Mean ◽  
Peripheral Origin

BACKGROND: Blepharospasm (BS) is a form of central focal dystonia recently associated with psychiatric disorders, particularly obsessive and compulsive symptoms. Hemifacial spasm (HFS) represents a focal myoclonus with peripheral origin in the facial nerve. OBJECTIVE: To determine the frequency of obsessive and compulsive symptoms in patients with BS in comparison with patients with HFS. METHODS: 30 patients from each group (BS and HFS) followed by the botulinum toxin clinic at the HC-UFPR were evaluated using a structured interview based on the DSM-IV criteria and the Yale-Brown scale. RESULTS: were compared by the mean two-tailed t test. RESULTS: We found obsessive or compulsive symptoms in 20 (66.6%) patients with BE and 21 (70%) with HFS. Yale-Brown scale scores for each group were higher among BS patients; however, diferences were not statisticaly significant. CONCLUSION: Our study did not show a significant diference in the comparison of the prevalence of obsessive and compulsive symptoms among patients with BS and HFS.

Prevalence of subthreshold forms of psychiatric disorders in persons making suicide attempts in Hungary

2000 ◽  
Vol 15 (6) ◽  
pp. 354-361 ◽  
Author(s):  
J. Balázs ◽  
I. Bitter ◽  
Y. Lecrubier ◽  
N Csiszér ◽  
G. Ostorharics
Keyword(s):  
Psychiatric Disorders ◽  
Suicide Attempts ◽  
Structured Interview ◽  
Background Information ◽  
Semistructured Interview ◽  
Suicide Attempters ◽  
Psychiatric Illnesses ◽  
Current Threshold ◽  
Axis I ◽  
Dsm Iv

summaryBackground – Suicide and suicide attempts have been associated to psychiatric illnesses; however, little is known about the role in suicide risk of those symptoms that do not meet the full criteria for a DSM-IV disorder. The aim of this study was to examine the prevalence of subthreshold psychiatric disorders among suicide attempters in Hungary. Methods – Using a modified structured interview (Mini International Neuropsychiatric Interview) determining 16 Axis I psychiatric diagnoses and their subthreshold forms defined by the DSM-IV and a semistructured interview collecting background information, the authors examined 140 consecutive suicide attempters, aged 18–65 years. Results – Eighty-three-point-six percent of the attempters had one or more current threshold diagnoses on Axis I and in addition more than three-quarters (78.6%) of the subjects had at least one subthreshold diagnosis. Six-point-four percent of the subjects (N = 9) had neither subthreshold nor threshold diagnoses at the time of their suicide attempts. Ten percent of the subjects (N = 14), not meeting the full criteria for any DSM-IV diagnoses, had at least one subthreshold diagnosis. In 68.6% of the subjects (N = 96), both subthreshold and threshold disorders were diagnosed at the time of their suicide attempts. The number of subthreshold and threshold diagnoses were positively and significantly related (χ2 = 5.12, df = 1, P < 0.05). Sixty-three-point-six percent of the individuals received two or more current threshold diagnoses on Axis I and 44.3% of the individuals (N = 62) had two or more subthreshold diagnoses at the time of their suicide attempts. Limitations – The subthreshold definitions in this study included only those forms of the disorders which required the same duration as the criteria DSM-IV disorder with fewer symptoms. Conclusions – Suicide attempts showed a very high prevalence of subthreshold disorders besides psychiatric disorders meeting the full criteria required according to the DSM-IV. Subthreshold forms of mental disorders need to be taken into account in suicide prevention.

scholarly journals Outcome of Injection Botulinum Toxin in Blepharospasm

2021 ◽  
Vol 13 (1) ◽  
pp. 40-49
Author(s):  
Malita Amatya ◽  
Ben Limbu ◽  
Purnima Rajkarnikar ◽  
Hom Bahadur Gurung ◽  
Rohit Saiju
Keyword(s):  
Botulinum Toxin ◽  
Hemifacial Spasm ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Line Treatment ◽  
First Line ◽  
Essential Blepharospasm ◽  
Meige Syndrome ◽  
The Mean ◽  
First Line Treatment

Introduction: Blepharospasm is a condition of involuntary spasm of the orbicularis oculi muscle which leads to intermittent or complete closure of the eyelids. Botulinum toxin is the currently recommended first line treatment for such blepharospasm. This study aims to find out the outcome of injection Botulinum toxin Type A in Blepharospasm. Materials and methods:  It was a hospital based, prospective, interventional study conducted on patients diagnosed as Benign essential blepharospasm (BEB), Meige syndrome (MS) and Hemifacial spasm (HFS) by oculoplastic surgeon at Oculoplasty department OPD, Tilganga Institute of Ophthalmology, from December 2018 to November 2019. After taking all standard precautions for botulinum toxin injections, 6 to 8 sites for injecting 2.5 to 5 IU of the toxin were given. All the patients were evaluated before and after injections according to Jankovic spasm grading and improvement in functional impairment scale and followed on one week, one month, three month and when the symptoms reappeared.  Results: A total of 43 cases which included 32 cases of Benign essential Blepharospasm, 9 Hemifacial spasm and 2 Meige syndrome. The mean Jankovic severity score was 3.51 ± 0.51 (range 3-4). The mean improvement in functional score was 2.60 ± 0.54 (range 1-3), was statistically significant (p-value <0.001).The effective period of injection was 130 ± 20.82 (93 – 189) days.38 patients had repeated injections after reappearance of symptoms. 4 patients had side effects of redness and hematoma at one site.  Conclusion: This study concludes that Botulinum toxin type A is effective in the management of Benign essential blepharospasm, Hemifacial spasm and Meige syndrome. This along with a good safety profile justifies its role as a first line treatment therapy in blepharospasm. However, it is a temporary treatment option where the effect lasts for a short period of time and repeated injections are required.

scholarly journals Botulinum Toxin Injections in the Treatment of Blepharospasm, Hemifacial Spasm, and Eyelid Fasciculations

1988 ◽  
Vol 15 (3) ◽  
pp. 276-280 ◽  
Author(s):  
Stephen P. Kraft ◽  
Anthony E. Lang
Keyword(s):  
Botulinum Toxin ◽  
Side Effects ◽  
Hemifacial Spasm ◽  
Average Duration ◽  
Systemic Reaction ◽  
Dry Eyes ◽  
The Third ◽  
Duration Of Response ◽  
The Mean ◽  
Botulinum Toxin Injections

ABSTRACT:Seventy-six patients with blepharospasm (mean age 56.9 years) received 248 injection treatments with botulinum A exotoxin (mean 3.1 treatments per patient): 87.0% of treatments led to total relief of spasms for a mean interval of 14.1 weeks. The average duration of response remained fairly constant over the first six injection series, although patients with the most severe spasms had shorter intervals than patients with less severe symptoms. Twenty patients with hemifacial spasm (mean age 56.9 years) received 44 treatments (mean 1.9 treatments per patient): In 93.1% of cases there was total relief of periocular and perioral spasms, with a mean interval of 17.4 weeks. The average duration of response for the third series of treatments was much shorter than the mean durations for the first two treatments. Side effects were always transient and included ptosis (23.3%), dry eyes (18.1%), tearing (5.5%), and strabismus (1.4%). No patient had a systemic reaction to the drug. Chronic benign eyelid fasciculations were also successfully treated in 3 patients with single treatments.

Utilization of 3D imaging reconstructions and assessment of symptom-free survival after microvascular decompression of the facial nerve in hemifacial spasm

2020 ◽  
Vol 133 (2) ◽  
pp. 425-432 ◽  
Author(s):  
Zoe E. Teton ◽  
Daniel Blatt ◽  
Katherine Holste ◽  
Ahmed M. Raslan ◽  
Kim J. Burchiel
Keyword(s):  
Facial Nerve ◽  
Transition Zone ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Three Dimensional ◽  
3D Reconstructions ◽  
Free Survival ◽  
The Mean ◽  
Telephone Questionnaire

OBJECTIVEHemifacial spasm (HFS), largely caused by neurovascular compression (NVC) of the facial nerve, is a rare condition characterized by paroxysmal, unilateral, involuntary contraction of facial muscles. It has long been suggested that these symptoms are due to compression at the transition zone of the facial nerve. The aim of this study was to examine symptom-free survival and long-term quality of life (QOL) in HFS patients who underwent microvascular decompression (MVD). A secondary aim was to examine the benefit of utilizing fused MRI and MRA post hoc 3D reconstructions to better characterize compression location at the facial nerve root exit zone (fREZ).METHODSThe authors retrospectively analyzed patients with HFS who underwent MVD at a single institution, combined with a modified HFS-7 telephone questionnaire. Kaplan-Meier analysis was used to determine event-free survival, and the Wilcoxon signed-rank test was used to compare pre- and postoperative HFS-7 scores.RESULTSThirty-five patients underwent MVD for HFS between 2002 and 2018 with subsequent 3D reconstructions of preoperative images. The telephone questionnaire response rate was 71% (25/35). If patients could not be reached by telephone, then the last clinic follow-up date was recorded and any recurrence noted. Twenty-four patients (69%) were symptom free at longest follow-up. The mean length of follow-up was 2.4 years (1 month to 8 years). The mean symptom-free survival time was 44.9 ± 5.8 months, and the average symptom-control survival was 69.1 ± 4.9 months. Four patients (11%) experienced full recurrence. Median HFS-7 scores were reduced by 18 points after surgery (Z = −4.013, p < 0.0001). Three-dimensional reconstructed images demonstrated that NVC most commonly occurred at the attached segment (74%, 26/35) of the facial nerve within the fREZ and least commonly occurred at the traditionally implicated transition zone (6%, 2/35).CONCLUSIONSMVD is a safe and effective treatment that significantly improves QOL measures for patients with HFS. The vast majority of patients (31/35, 89%) were symptom free or reported only mild symptoms at longest follow-up. Symptom recurrence, if it occurred, was within the first 2 years of surgery, which has important implications for patient expectations and informed consent. Three-dimensional image reconstruction analysis determined that culprit compression most commonly occurs proximally along the brainstem at the attached segment. The success of this procedure is dependent on recognizing this pattern and decompressing appropriately. Three-dimensional reconstructions were found to provide much clearer characterization of this area than traditional preoperative imaging. Therefore, the authors suggest that use of these reconstructions in the preoperative setting has the potential to help identify appropriate surgical candidates, guide operative planning, and thus improve outcome in patients with HFS.

scholarly journals Causes for Treatment Delays in Dystonia and Hemifacial Spasm: A Canadian Survey

2011 ◽  
Vol 38 (5) ◽  
pp. 704-711 ◽  
Author(s):  
Mandar Jog ◽  
Sylvain Chouinard ◽  
Doug Hobson ◽  
David Grimes ◽  
Robert Chen ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Movement Disorders ◽  
Hemifacial Spasm ◽  
Primary Care Physicians ◽  
Access To Treatment ◽  
Treatment Delays ◽  
Complex Disorder ◽  
Specialist Centre ◽  
Survey Results ◽  
The Mean

Background:Dystonia must be accurately diagnosed so that treatment can be administered promptly. However, dystonia is a complex disorder, with variable presentation, which can delay diagnosis.Methods:Data were gathered by questionnaire from 866 patients with dystonia or hemifacial spasm (HFS) treated in 14 movement disorders centres in Canada injecting botulinum toxin, to better understand the path to diagnosis, wait times and obstacles to treatment.Results:Most participants were female (64.1%), mean age was 58 years, and patients consulted an average of 3.2 physicians before receiving a dystonia or HFS diagnosis. Many patients (34%) received other diagnoses before referral to a movement disorders clinic, most commonly “stress” (42.7%). A variety of treatments were often received without a diagnosis. The mean lag time between symptom onset and diagnosis was 5.4 years. After the decision to use botulinum toxin, patients waited a mean of 3.1 months before treatment. The most common diagnoses were cervical dystonia (51.6% of patients), HFS (20.0%) and blepharospasm (9.8%).Conclusions:Survey results show that diagnosis of dystonias or of HFS, and therefore, access to treatment, is delayed. An educational program for primary care physicians may be helpful to decrease the time to diagnosis and referral to a specialist centre for treatment.

Clinical Utility of the MMPI-2-RF Hierarchical Description

2020 ◽  
Vol 36 (5) ◽  
pp. 907-912
Author(s):  
Hilde De Saeger ◽  
Jan H. Kamphuis ◽  
Jaime L. Anderson
Keyword(s):  
Personality Disorder ◽  
Clinical Utility ◽  
Minnesota Multiphasic Personality Inventory ◽  
Model Description ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Scale Scores ◽  
Dsm Iv ◽  
The Mean

Abstract. Several studies have addressed the associations between the Minnesota Multiphasic Personality Inventory-2 Restructured form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 ) scale scores and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013 ) Section II personality disorder (PD) criterion counts. While these studies showed which variables were associated with the PDs as well as their combined predictive potency, no information is available on mean patterns of elevation associated with these conditions. To illustrate how the MMPI-2-RF information may amplify categorical diagnostic information, we describe the mean RF profiles of a psychiatric sample with a Cluster C PD diagnosis. PD classification was based on the Structured Clinical Interview for the DSM-IV (SCID-II). Patterns of elevation across the three levels of the MMPI-2-RF scale sets were consistently in line with theoretical expectation. In addition, elevated scores on somatic/cognitive scales were noted. It is concluded that the MMPI-2-RF can enhance DSM Personality disorder model description.

Psychoaffective Immaturity in Psychiatric Disorders

2001 ◽  
Vol 88 (1) ◽  
pp. 111-114 ◽  
Author(s):  
G. Loas ◽  
A. Seillier ◽  
C. Fréville
Keyword(s):  
Substance Use ◽  
Psychiatric Disorders ◽  
Social Functioning ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Assessment Scale ◽  
Scale Scores ◽  
The Mean ◽  
Emotional Immaturity ◽  
Functioning Assessment

This study investigated the prevalence of psychoaffective immaturity and tested the hypothesis that it associated with bad prognosis. For 135 psychiatric patients meeting criteria for personality, neurotic, affective, substance use, or psychotic disorders emotional immaturity was rated using the 1985 diagnostic criteria of Doutheau, Dubertret, Moutin, and Barrois. 58 subjects (42.96%, 95% Confidence Interval: 34.61–51.31) were classified as immature. Scores of the Nonimmature and Immature groups were compared for the Beck Depression Inventory and the Professional and Social Functioning Assessment Scale. Scores were, respectively, significantly higher and lower in those patients classified as Immature than those who were classified Nonimmature. When depression was controlled by a covariance analysis, the mean difference on the Professional and Social Functioning Assessment Scale remained significant. It appears that psychoaffective immaturity is a factor associated with severity of psychiatric disorders.

scholarly journals Botulinum toxin type A in the treatment of hemifacial spasm: an 11-year experience

2010 ◽  
Vol 68 (4) ◽  
pp. 502-505 ◽  
Author(s):  
Egberto Reis Barbosa ◽  
Leonel Tadao Takada ◽  
Lilian Regina Gonçalves ◽  
Rose Mary Paulo do Nascimento Costa ◽  
Laura Silveira-Moriyama ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Hemifacial Spasm ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
School Of Medicine ◽  
Long Term Effect ◽  
Subjective Judgement ◽  
The Mean

In order to evaluate the long-term effect of botulinum toxin type A (BTX) in the treatment of hemifacial spasm (HFS), a retrospective analysis of patients treated at the Movement Disorders Unit of the Division of Neurology, Clinical Hospital, University of São Paulo, School of Medicine from 1993 to 2004 was made. A total of 808 injections with BTX were administered to 54 patients with HFS. The mean duration of improvement per application was 3.46 months and the mean rate of improvement using subjective judgement by the patient was of 83%. Adverse effects, mostly minor, were observed in 64.8% of patients at least once along the period of follow-up and the most frequent of them was orbicularis oris paralysis (38.8%). There was no decrement in response when compared the first and the last injection recorded.

scholarly journals Botulinum Toxin for the Treatment of Hemifacial Spasm: An Update on Clinical Studies

Toxins ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 881
Author(s):  
Nicola Tambasco ◽  
Marta Filidei ◽  
Pasquale Nigro ◽  
Lucilla Parnetti ◽  
Simone Simoni
Keyword(s):  
Botulinum Toxin ◽  
Hemifacial Spasm ◽  
Rating Scales ◽  
Spontaneous Recovery ◽  
Poor Quality ◽  
Optimal Timing ◽  
Seventh Cranial Nerve ◽  
Injection Techniques ◽  
The Mean

Hemifacial spasm (HFS) is a movement disorder characterized by involuntary contractions of the facial muscles innervated by the seventh cranial nerve. Generally, it is associated with a poor quality of life due to social embarrassment and can lead to functional blindness. Moreover, it is a chronic condition, and spontaneous recovery is rare. Intramuscular injections of Botulinum Toxin (BoNT) are routinely used as HFS treatment. Methods: We reviewed published articles between 1991 and 2021 regarding the effectiveness and safety of BoNT in HFS as well as any reported differences among BoNT formulations. Results: The efficacy of BoNT for HFS treatment ranged from 73% to 98.4%. The mean duration of the effect was around 12 weeks. Effectiveness did not decrease over time. Adverse effects were usually mild and transient. The efficacy and tolerability of the different preparations appeared to be similar. Among the studies, dosage, injected muscles, intervals of treatment, and rating scales were variable, thus leading to challenges in comparing the results. Conclusions: BoNT was the treatment of choice for HFS due to its efficacy and safety profile. Further studies are needed to investigate the factors that influence the outcome, including the optimal timing of treatment, injection techniques, dosage, and the best selection criteria for formulations.

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