Video analysis of patients with blepharospasm and lower face dystonias

Abstract

Background: Blepharospasm (BSP) is a focal dystonia. There is a lack of standardization in the length of time necessary to get a measure of BSP severity for rating scales.Objectives: 1) Determine the difference between evaluating the number of eye closures in patients with blepharospasm in 1 vs. 2 min. 2) Characterize the prevalence, phenomenology and concordance of sensory trick in subjects with only blepharospasm compared to those with blepharospasm associated with other dystonias of the head.Methods: Thirty-eight, 2-min-long standardized videos of subjects with BSP without any other dystonias were reviewed (group1). Eye closure rate was measured in 0–60 s vs. 60–120 s. Wilcoxon signed-rank test and Spearman correlation coefficient were used to compare the eye closure rate between these two intervals. An additional 68 standardized videos of subjects with blepharospasm associated with dystonia of the head were reviewed (group2). Presence, phenomenology and concordance between what subjects verbally reported as their sensory trick and what they demonstrated was classified for both groups then qualitatively compared.Results/conclusion: Eye closure rates between 0–60 s and 0–120 s were not statistically different. There is no added benefit of counting the number of eye closures in 2 min, compared to 1 min, in patients with BSP. Sensory trick was reported by 57% of subjects with BSP and 80% of subjects who have blepharospasm and other dystonias of the head. With 100% and 97% concordance, patients’ self-reported sensory trick accurately describes the movements that alleviate their dystonic movements.