• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.164-172
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• 2002

The role of botulinum toxin as a therapeutic agent is expanding rapidly in otolaryngology. Botulinum toxin is a protease that blocks the release of acetylcholine from nerve terminals. Its effects are transient and nondestructive, and largely limited to the area in which it is administered These effects are also graded according to the dose, allowing for individualized treatment of patients and disorders. Botulinum toxin has been used primarily to treat disorders of excessive or inappropriate muscle contraction. In the field of otolaryngology, these include spasmodic dysphonia, oromandibular dystonia, and blepharospasm, vocal tics and stuttering, cricopharyngeal achalasia, various tremors and tics, hemifacial spasm, temporomandibular joint disorders and a number of cosmetic applications. Botulinum toxin treatment has recently begun to show some benefit in the control of pain from migraine and tension headache. It may also prove useful in the control of autonomic dysfunction, as in Frey syndrome, sialorrhea, and rhinorrhea. In over 20 yews of use in humans, botulinum toxin has accumulated a considerable safety record, and in many cases represents relief for thousands of patients unaided by other therapy.

• The Journal of Dong Guk Oriental Medicine
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• v.7 no.2
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• pp.69-79
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• 1999

Hemifacial spasm including blepharospasm is characterized by spontaneous clonic an d tonic muscle spasm on one side of the face with synkinesis. Though the etiology of hemifacial spasm is not entirely understood, generally there are two. One is nuclear hypothesis and the other is peripheral hypothesis. There are two ways of treatment of hemifacial spasm. One is internal medicine and the other is operative method. In oriental medicine, hemifacial spasm is very similar to diseases such as Anpojindo (眼胞振跳), Poryunjindo(胞輪振跳), or Aunido(眼眉跳) in symptoms. The diseases such as Anpojindo(眼胞振跳), Poryunjindo(胞輪振跳), Anmido(眼眉跳) is related to the function of liver(肝) and risk factors are regarded as Pung(風). The acupuncture therapy of hemifacial spasm is based on Liver meridian(LV), Gallbladder meridian(GB). And ear-acupuncture is recommended as a good method for hemifacial spasm.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.63-66
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• 2002

Blepharospasm and apraxia of lid opening(ALO) are non-paralytic causes of involuntary eyelid closure. Clinically it is difficult to differentiate blepharospasm and ALO, and these two conditions are sometimes associated. We report a case of pretarsal blepharospasm presenting as apraxia of lid opening. 55-year-old woman was noted to have voluntary eye opening difficulty. We synchronously record the electromyographic(EMG) from the levator palpebrae superioris and the orbicularis oculi muscles in this patient. This results suggested that she has a variant of blepharospasm due to abnormal contraction in the pretarsal orbicularis oculi.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.4
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• pp.391-398
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• 2013

Botulinum toxin has been used for treating strabismus, blepharospasm, cerebral palsy, cervical dystonia, hyperhydrosis, facial wrinkle and chronic migraine under US Food and Drug administration approval. Also it has been tried spasticity-induced pain, post-herpetic neuralgia, myofascial pain and aphthous ulcer as off-label use. In this study, we reviewed recent studies that suggested effects of botulinum toxin on snoring and sleep apnea.

• The Journal of the Society of Stroke on Korean Medicine
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• v.15 no.1
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• pp.80-84
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• 2014

■ Objectives The purpose of this clinical study is to evaluate the effect of Traditional Korean Medicine(TKM) on a patient with forcible closure of the eyelids due to blepharospasm. ■ Methods A patient with forcible closure of the eyelids diagnosed as blepharospasm was treated with herbal medication, acupuncture, electro-acupuncture, cupping and moxibustion. Then we evaluated the improvement with length of eye opening and Blepharospasm Disability Index. ■ Results Increase of length of eye opening and Blepharospasm Disability Index were observed after the TKM treatment. ■ Conclusion This study proved the effect of TKM treatment on forcible closure of the eyelids due to blepharospasm.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.17 no.3
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• pp.103-108
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• 2017

Kabuki syndrome is a rare congenital disorder that causes multiple birth defects and mental retardation. Mutation of the lysine methyltransferase 2D (KMT2D) gene is the primary cause of Kabuki syndrome. We report a 4-year-old Korean girl diagnosed with Kabuki syndrome based on distinctive facial features (eversion of the lower lateral eyelid, arched eyebrows, depressed nasal tip, prominent ears), skeletal anomalies, short stature, and molecular analysis, which revealed a novel frameshift mutation in the KMT2D gene. A 4-year-old patient had a past history of congenital cardiac malformations (coarctation of the aorta, ventricular septal defect, atrial septal defect, patent ductus arteriosus), subclinical hypothyroidism and dysmorphic features at birth including webbed neck, short fingers, high arched palate, micrognathia and horseshoe kidney. She showed unique facial features such as a long palpebral fissure, long eyelashes, arched eyebrows with sparseness of the lateral third, broad nasal root, anteverted ears, and small mouth. Her facial features suggested Kabuki syndrome, and genetic analysis discovered a novel heterozygous frameshift mutation (c.4379dup, p.Leu1461Thrfs*30) in exon 15 of the KMT2D gene. The diagnosis of our 4-year-old patient was made through thorough physical examination and history taking, and genetic testing. It is challenging to diagnose patients with Kabuki syndrome at birth, since the characteristic facial features are expressed gradually during growth. Clinical suspicion aroused by regular follow-ups may lead to earlier diagnosis and interventions.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.22 no.2
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• pp.153-162
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• 2009

Objectives : This study was performed to observe 47 cases of patients with blepharospasm treated with Wisunghanggyeok(胃勝寒格). Methods : For 28 months from Sep. 2006 to Dec. 2008, we researched 47 blepharospasm patients treated with Wisunghanggyeok(胃勝寒格) who visited the author's clinic. Results & Conclusion: 1. It shows more female patients than male patients, and mostly patients in their fifties. 2. The lesion is shown more on the right side than on the left side, and the left side blepharospasm is cured more effective. 3. The causes of hemifacial spasm are mainly stress and overwork, and there is a 85% improvement of 39 cases from these two causes. 4. The disease period is mainly within 1 week, and that period is the most effective time. 5. The number of treatment is mainly under 5 times, and the effect of treatment over 4 times for week is more available. 6. There are 59.57% of excellent improvement and 23.4% of good improvement, and these make 82.97% improvement of 47cases.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.751-754
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• 2010

A 6-year-old spayed female Persian cat presented with a 3-month history of recurrent ulcerative keratitis with noticeable opacification and vascularization of the right cornea. The lesion was nonresponsive to topical antibiotics and to nonsteroidal anti-inflammatory drugs. Ophthalmic examination showed signs of ocular discomfort, such as epiphora and blepharospasm, in the right eye. Biomicroscopic examination revealed an irregular, edematous, vascularized mass with pink to white tissue on the entire cornea and mild conjunctivitis. A tentative diagnosis of feline proliferative eosinophilic keratitis (FPEK) was made on the basis of clinical appearance. Cytologic examination of the cornea showed a mixture of numerous eosinophils and mast cells, which confirmed the original diagnosis of FPEK. The cat was treated with a topical antibiotic-corticosteroid combination, cyclosporine ointment, trifluridine eye drops, and oral Llysine. The clinical signs improved remarkably 18 days after the cat was first examined. The short-term use of corticosteroids and long-term use of cyclosporine and an anti-viral agent resolved the lesion without recurrence of the disease for 1 year.

• The Journal of the Society of Stroke on Korean Medicine
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• v.7 no.1
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• pp.46-53
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• 2006

Objectives : The purposes of this study were to investigate that a blepharospasm means the presymptom of stroke based on the traditional hypothesis in the oriental medicine and to compare a blepharospasm with warning signs of stroke in the western medicine. Methods : In the time period Oct. 2005 to Oct. 2006, 409 patients with a first-ever stroke admitted in the department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital, Kyunghee University Oriental Medical Hospital, Dongguk Il-san Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. Stroke patients were interviewed by residents who studied standard operation procedures in Fundamental Study for Standardization and Objectification of Differentiation and Pattern Identification of Syndrome of Oriental Medicine for Stroke. A questionnaire was completed by a question-and-answer form between patients and residents after explanation details to patients and the agreement of patients. Results : Age, care of patients or grandson, diabetes mellitus, and smoking were higher among cerebral infarction group, while smoking was higher among hemorrhage group. Female, young age, hyperlipidemia, hypertension in the family history and fat body in waist-hip ratio were higher among patients undergoing the blepharospasm before stroke onset. And the incidence of blepharospasm was lower in patients who dislike the fast food. Finally, when we compared a blepharospasm with warning signs of stroke in the western medicine, the incidence of blepharospasm in this study were the most frequent. Conclusion : In this study, the incidence of blepharospasm in patients before stroke onset was more frequent than that of warning signs in the western medicine. But more data from prospective cohort studies should be collected to be accepted that the blepharospasm is the presymptom of stroke as like warning signs in the western medicine.