良性特发性眼睑痉挛的研究进展

Progress of benign essential blepharospasm

良性特发性眼睑痉挛是以不自主双眼闭合并睁开费力为特征的局灶性肌张力障碍性疾病。目前病因及发病机制不清,多数成年起病,女性多发。症状通常是由压力、疲劳、强烈的光照或个人因素等引起的。通常病情进展缓慢,晚期患者可出现功能性盲影响生活,目前主要治疗方法包括:肉毒毒素注射、外科手术、系统性和眼部药物以及中医药治疗。肉毒菌素治疗是一种有效的治疗方法,外科手术效果较满意但有一定适应证,适用于对肉毒杆菌毒素治疗无效患者。药物治疗疗效甚微,中医药治疗有一定治疗效果,经颅磁刺激可改善患者症状。本文就该病的流行病学、解剖学、生理学、临床表现、鉴别诊断、发病机制以及治疗等方面进行系统综述。

Blepharospasm is a focal dystonia of the orbicularis oculi muscles, producing excessive eye closure. The etiology and pathogenesis is still unclear now. lt is usually appearing in adult period and predominant in females. The symptoms are typically triggered by stress, fatigue, intense light or individual factors. At advanced stages patients develop functional blindness. At present the main treatments include： botulinum toxin （ BTX ） , surgical procedures, systemic and ocular drugs and traditional Chinese medicine treatment. BTX administration has been an effective treatment. Surgical procedures have good effect but should be limited to the rare patients that do not respond to botulinum toxin treatment. A great variety of drugs have poor results. Chinese medicine has a certain therapeutic effect. Transcranial magnetic stimulation can improve symptoms. The epidemiology, anatomy, physiology, clinical manifestations, differential diagnosis, pathogenesis and treatment system were reviewed in this paper.