Tratamento cirúrgico do blefaroespasmo essencial: relato de dois pacientes

Arquivos de Neuro-Psiquiatria (Impact Factor: 1.01). 01/1999; DOI: 10.1590/S0004-282X1999000300021
Source: DOAJ

ABSTRACT Blefaroespasmo essencial pode ser tratado por diversas opções terapêuticas: clínicas em que se destaca entre outros o uso da toxina botulínica com suas vantagens e limitações, e algumas opções de tratamento cirúrgico. A técnica cirúrgica proposta por Gillum e Anderson oferece uma alternativa a pacientes resistentes ao tratamento clínico ou que durante a evolução da doença apresentem complicações secundárias. São analisados dois casos em que se indicou a miectomia dos músculos orbicular da pálpebra, prócero e corrugador do supercílio associados à blefaroplastia e ritidoplastia frontal por terem apresentado diminuição da resposta ao tratamento clínico. Ambos obtiveram bons resultados, retornando às suas atividades normais.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Seventeen patients with intractable blepharospasm underwent bilateral percutaneous fractional thermolytic destruction of branches of the facial nerve. Thirteen were women and four men; their ages ranged from 46 to 76 years with an average of 62 years. Since local and intravenous analgesia were used, the patients were awake and cooperative, resulting in minimal complications. In this series, patients had an average improvement of 69%. Minimal scarring results from the percutaneous route and these patients may undergo staged procedures for further relief of their symptoms.
    Ophthalmic surgery 12/1981; 12(11):823-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Motor tics of the head and neck, especially hemifacial spasm and spastic torticollis, are the substance of this paper. Forty-six cases are presented, and surgical techniques are described. In hemifacial spasm the intracranial neurovascular lysis of Jannetta is a valid operation with the best results to date but has a 7 1/2% risk of unilateral deafness. The extracranial submastoid partial section of Scoville is completely safe and gives excellent results, but there is a probability of mild to moderate return of the spasm in one to two year's time. In spastic torticollis the accepted radical operation consists of bilateral anterior rhizotomy of the upper three roots plus bilateral spinal accessory nerve section in the neck. A tragic complication of this operation has recently been observed by ourselves, Sweet, and Hamlin. This complication is bilateral infarction of the medulla (bilateral Wallenberg's syndrome). This has also been reported as occurring following chiropractic manipulations. For this reason the writer does limited unilateral sectioning of the spinal accessory nerve in the neck and resection of the upper third of the sternomastoid muscle, as a first stage procedure, in those cases in which rotation of the neck is the principal symptom, before doing the radical operation. Safeguards to prevent this complication include preoperative vertebral arteriography and preservation of both motor and sensory radicular arteries under magnification and maintenance of adequate neck support during the early postoperative days.
    Acta Neurochirurgica 02/1979; 48(1-2):47-66. DOI:10.1007/BF01406020 · 1.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A family study in 29 patients with idiopathic adult-onset blepharospasm (n = 16) and cranial-cervical dystonia (n = 13) was undertaken by examining 189 first-degree relatives. Six relatives with dystonia were identified in 6 families. A further 3 affected relatives, now deceased, were from 2 other families. All the secondary cases were parents or siblings. There was a tendency for affected relatives to have the same type of dystonia of index patients. To assess the significance of secondary cases we compare the incidence of affected siblings between probands and their spouses. Dystonia was found in 5 out of 120 proband siblings whereas none of the 142 spouse siblings was affected (p < 0.05). Segregation analysis suggested an autosomal-dominant transmission and reduced penetrance or, alternatively, polygenic inheritance.
    European Neurology 02/1993; 33(5):345-50. DOI:10.1159/000116969 · 1.36 Impact Factor

Full-text (2 Sources)

Available from
Jan 21, 2015