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Xu J, Zhang X, Cheng Q, Zhang H, Zhong L, Luo Y, Zhang Y, Ou Z, Yan Z, Peng K, Liu G. Abnormal supplementary motor areas are associated with idiopathic and acquired blepharospasm. Parkinsonism Relat Disord 2024; 121:106029. [PMID: 38394948 DOI: 10.1016/j.parkreldis.2024.106029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
Blepharospasm is a common form of focal dystonia characterized by excessive and involuntary spasms of the orbicularis oculi. In addition to idiopathic blepharospasm, lesions in various brain regions can also cause acquired blepharospasm. Whether these two types of blepharospasm share a common brain network remains largely unknown. Herein, we performed lesion coactivation network mapping, based on meta-analytic connectivity modeling, to test whether lesions causing blepharospasm could be mapped to a common coactivation brain network. We then tested the abnormality of the network in patients with idiopathic blepharospasm (n = 42) compared with healthy controls (n = 44). We identified 21 cases of lesion-induced blepharospasms through a systematic literature search. Although these lesions were heterogeneous, they were part of a co-activated brain network that mainly included the bilateral supplementary motor areas. Coactivation of these regions defines a single brain network that encompasses or is adjacent to most heterogeneous lesions causing blepharospasm. Moreover, the bilateral supplementary motor area is primarily associated with action execution, visual motion, and imagination, and participates in finger tapping and saccades. They also reported decreased functional connectivity with the left posterior cingulate cortex in patients with idiopathic blepharospasm. These results demonstrate a common convergent abnormality of the supplementary motor area across idiopathic and acquired blepharospasms, providing additional evidence that the supplementary motor area is an important brain region that is pathologically impaired in patients with blepharospasm.
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Affiliation(s)
- Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xiaodong Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China; Shenzhen Children's Hospital, Shenzhen, 518000, China
| | - Qinxiu Cheng
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Haoran Zhang
- Institute of Biomedical and Health Engineering, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Linchang Zhong
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yuhan Luo
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, 510080, China
| | - Yue Zhang
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, 510080, China
| | - Zilin Ou
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, 510080, China
| | - Zhicong Yan
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, 510080, China
| | - Kangqiang Peng
- Department of Medical Imaging, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
| | - Gang Liu
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, National Key Clinical Department and Key Discipline of Neurology, Guangzhou, 510080, China.
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Gameiro GR, Yabumoto C, Osaki MH, Monteiro LG, Schor P, Osaki TH. Objective demonstration of eyelid spasm relief with smartphone and custom software in hemifacial spasm patients. Int Ophthalmol 2024; 44:144. [PMID: 38498055 DOI: 10.1007/s10792-024-03070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE To objectively demonstrate eyelid spasms relief in hemifacial spasm (HFS) patients using a smartphone and a custom-made software. METHODS Nineteen patients with HFS had standardized videos recorded with a smartphone (iPhone 6S, Apple) camera before and 15 days after receiving onabotulinumtoxinA injections. Nineteen age-matched control subjects were also assessed. The Eye Aspect Ratio (EAR) is an algorithm previously described to determine whether the eye is opened or closed. When the eye is closed, EAR tends to be closer to zero. Analogously, if the eye is wide open, values are greater. A custom-made software using the EAR concept was developed and pre- and post-treatment EARs were analyzed to assess HFS patients. RESULTS Botulinum toxin (BoNT) injections led to a significant increase in the average EAR of the affected side: + 10.4% (p = 0.0175) of HFS patients, compared to baseline. Mean EAR before BoNT applications were significantly lower (16.2%) on the affected side (0.25 ± 0.05) of HFS patients when compared to controls (0.30 ± 0.05, p = 0.004). After BoNT injections, no statistically significant difference was observed for the average EAR between the affected side of HFS patients (0.27 ± 0.04) and controls (p = 0.20). CONCLUSIONS Use of a smartphone and custom-made software objectively demonstrated eyelid spasm relief in patients with HFS. Additional refinement of this system could permit more accurate assessments of treatment response rates for each patient, making it possible to be used in clinical practice.
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Affiliation(s)
- Gustavo R Gameiro
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cristina Yabumoto
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
| | - Midori H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
- Eye & Eyelid Experts, R. Joao Moura, 661, cj 84, 05412-001, São Paulo, SP, Brazil
| | - Lucas G Monteiro
- Department of Ophthalmology, University of Santo Amaro (UNISA), São Paulo, SP, Brazil
| | - Paulo Schor
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil
| | - Tammy H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, R. Botucatu, 822, 04023-062, São Paulo, SP, Brazil.
- Eye & Eyelid Experts, R. Joao Moura, 661, cj 84, 05412-001, São Paulo, SP, Brazil.
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Balas M, Janic A, Daigle P, Nijhawan N, Hussain A, Gill H, Lahaie GL, Belliveau MJ, Crawford SA, Arjmand P, Ing EB. Evaluating ChatGPT on Orbital and Oculofacial Disorders: Accuracy and Readability Insights. Ophthalmic Plast Reconstr Surg 2024; 40:217-222. [PMID: 37989540 DOI: 10.1097/iop.0000000000002552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
PURPOSE To assess the accuracy and readability of responses generated by the artificial intelligence model, ChatGPT (version 4.0), to questions related to 10 essential domains of orbital and oculofacial disease. METHODS A set of 100 questions related to the diagnosis, treatment, and interpretation of orbital and oculofacial diseases was posed to ChatGPT 4.0. Responses were evaluated by a panel of 7 experts based on appropriateness and accuracy, with performance scores measured on a 7-item Likert scale. Inter-rater reliability was determined via the intraclass correlation coefficient. RESULTS The artificial intelligence model demonstrated accurate and consistent performance across all 10 domains of orbital and oculofacial disease, with an average appropriateness score of 5.3/6.0 ("mostly appropriate" to "completely appropriate"). Domains of cavernous sinus fistula, retrobulbar hemorrhage, and blepharospasm had the highest domain scores (average scores of 5.5 to 5.6), while the proptosis domain had the lowest (average score of 5.0/6.0). The intraclass correlation coefficient was 0.64 (95% CI: 0.52 to 0.74), reflecting moderate inter-rater reliability. The responses exhibited a high reading-level complexity, representing the comprehension levels of a college or graduate education. CONCLUSIONS This study demonstrates the potential of ChatGPT 4.0 to provide accurate information in the field of ophthalmology, specifically orbital and oculofacial disease. However, challenges remain in ensuring accurate and comprehensive responses across all disease domains. Future improvements should focus on refining the model's correctness and eventually expanding the scope to visual data interpretation. Our results highlight the vast potential for artificial intelligence in educational and clinical ophthalmology contexts.
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Affiliation(s)
| | | | - Patrick Daigle
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Navdeep Nijhawan
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ahsen Hussain
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Harmeet Gill
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Gabriela L Lahaie
- Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada
| | - Michel J Belliveau
- Department of Ophthalmology, University of Ottawa and The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sean A Crawford
- Temerty Faculty of Medicine
- Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Edsel B Ing
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology and Vision Sciences, University of Alberta, Edmonton, Alberta, Canada
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Al-Hashel JY, Soliman DY, Ismail II. New-Onset Focal Task Specific Oromandibular Dystonia in Association with Quran Recitation: A Case Series. Tremor Other Hyperkinet Mov (N Y) 2024; 14:3. [PMID: 38222897 PMCID: PMC10785953 DOI: 10.5334/tohm.849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024] Open
Abstract
Background Focal task-specific dystonia is a form of isolated focal dystonia that occurs during the performance of a specific skilled motor task. The occurrence of oromandibular dystonia (OMD) specifically in association with the recitation of Quranic verses have been rarely reported in the literature, in non-native Arabic-speaking patients. This case series describe a rare type of focal task-specific dystonia that occurs exclusively by reciting Quran in native Arabic-speaking patients, which has never been reported, to the best of our knowledge. Methods In this case series, we identified five patients with new-onset OMD that was exclusively induced by reciting Quran. Cases were evaluated in our Movement Disorders outpatient clinic at Ibn Sina hospital; the main tertiary neurology center in Kuwait, between 2015 and 2023. Results Five cases (3 males, 2 females) were identified in this study. Mean age of onset of the symptoms was 52.3 ± 4.1 years, while the median duration of the symptoms prior to diagnosis was 3 years. All patients were native Arab-speaking, with no previous history of other types of dystonia. No identifiable risk factors could be obtained including exposure to dopamine blocking agents or antipsychotics, or history of oral or dental surgery. Patients underwent a full clinical, laboratory, and radiological evaluation. All patients had OMD dystonia in varying forms and severity, while two patients had additional spasmodic dysphonia/ blepharospasm on progressive recitation. Most patients had minimal improvement with combination of oral medications and speech therapy. Four patients received botulinum toxin injections with better results. Discussion The mental and physical stress in attempting to recite the Quranic verses could have contributed to the development of OMD. Moreover, the increased demand on the muscles of the jaw, lips, and tongue during recitation can trigger the dystonic symptoms. Highlights OMD exclusively during Quran recitation is a rare phenomenon, and expands the spectrum of task-specific focal dystonia described in the literature. It was found to be distressing to the patients and a challenge to treat. Prompt recognition could minimize unnecessary testing and procedures, and facilitate earlier treatment.
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Affiliation(s)
- Jasem Youssef Al-Hashel
- Department of Neurology, Ibn Sina Hospital, Kuwait
- Department of Medicine, Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait
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Kamble N, Pal PK. Electrophysiology in Functional Movement Disorders: An Update. Tremor Other Hyperkinet Mov (N Y) 2023; 13:49. [PMID: 38162980 PMCID: PMC10756160 DOI: 10.5334/tohm.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
Background Functional movement disorders (FMD) are a diagnostic and therapeutic challenge, both to the neurologist and psychiatrists. The phenomenology is varied and can present as tremors, dystonia, jerks/myoclonus, gait disorder, other abnormal movements or a combination. There has been an increase in the use of electrophysiological studies that are an important tool in the evaluation of FMDs. Methods We searched the database platforms of MEDLINE, Google scholar, Web of Sciences, Scopus using the Medical Subject Heading terms (MeSH) for all the articles from 1st January 1970 till November 2022. A total of 658 articles were obtained by the search mechanism. A total of 79 relevant articles were reviewed thoroughly, of which 26 articles that had electrophysiological data were included in the present review. Results Variability, distractibility and entertainability can be demonstrated in functional tremors by using multichannel surface electromyography. Voluntary ballistic movements tend to decrease the tremor, while loading the tremulous limb with weight causes the tremor amplitude to increase in functional tremor. Presence of Bereitschaftspotential demonstrates the functional nature of palatal tremor and myoclonus. Co-contraction testing may be helpful in differentiating functional from organic dystonia. The R2 blink reflex recovery cycle has been found to be abnormally enhanced in organic blepharospasm, whereas it is normal in presumed functional blepharospasm. Plasticity is found to be abnormally high in organic dystonia and normal in functional dystonia, in addition to enhanced facilitation in patients with organic dystonia. Conclusions Electrophysiological tests supplement clinical examination and helps in differentiating FMD from organic movement disorders.
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Affiliation(s)
- Nitish Kamble
- Departments of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bengaluru-560029, Karnataka, India
| | - Pramod Kumar Pal
- Departments of Neurology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Hosur Road, Bengaluru-560029, Karnataka, India
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Defazio G, Gigante AF, Hallett M, Berardelli A, Perlmutter JS, Berman BD, Jankovic J, Bäumer T, Comella C, Ercoli T, Ferrazzano G, Fox SH, Kim HJ, Moukheiber ES, Richardson SP, Weissbach A, Jinnah HA. Motor and psychiatric features in idiopathic blepharospasm: A data-driven cluster analysis. Parkinsonism Relat Disord 2022; 104:94-98. [PMID: 36306537 DOI: 10.1016/j.parkreldis.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/05/2022] [Accepted: 10/07/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Idiopathic blepharospasm is a clinically heterogeneous dystonia also characterized by non motor symptoms. METHODS We used a k-means cluster analysis to assess 188 patients with idiopathic blepharospasm in order to identify relatively homogeneous subpopulations of patients, using a set of motor and psychiatric variables to generate the cluster solution. RESULTS Blepharospasm patients reached higher scores on scales assessing depressive- and anxiety-related disorders than healthy/disease controls. Cluster analysis suggested the existence of three groups of patients that differed by type of spasms, overall motor severity, and presence/severity of psychiatric problems. The greater severity of motor symptoms was observed in Group 1, the least severity in Group 3, while the severity of blepharospasm in Group 2 was between that observed in Groups 1 and 3. The three motor subtypes also differed by psychiatric features: the lowest severity of psychiatric symptoms was observed in the group with least severe motor symptoms (group 3), while the highest psychiatric severity scores were observed in group 2 that carried intermediate motor severity rather than in the group with more severe motor symptoms (group 1). The three groups did not differ by disease duration, age of onset, sex or other clinical features. CONCLUSIONS The present study suggests that blepharospasm patients may be classified in different subtypes according to the type of spasms, overall motor severity and presence/severity of depressive symptoms and anxiety.
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Affiliation(s)
- Giovanni Defazio
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Mark Hallett
- Human Motor Control Section, NINDS, NIH, Bethesda, MD, USA
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy; IRCCS NEUROMED, Pozzilli, Italy
| | - Joel S Perlmutter
- Neurology, Radiology, Neuroscience, Physical Therapy, Occupational Therapy, Washington University in St. Louis, St Louis, MO, USA
| | | | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Tobias Bäumer
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | | | - Tommaso Ercoli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gina Ferrazzano
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Susan H Fox
- Toronto Western Hospital, Krembil Brain Institute, University of Toronto, Canada
| | - Han-Joon Kim
- Department of Neurology and Movement Disorder Centre, Seoul National University Hospital, Seoul, South Korea
| | | | | | - Anne Weissbach
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA; Institute of Systems Motor Science and Institute of Neurogenetics, University of Lübeck, Germany
| | - Hyder A Jinnah
- Department of Neurology and Human Genetics, Emory University, Atlanta, GA, USA
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Liu Y, Hao X, Zhou D, Hong Z. Relapsing and Immune-Responsive Paroxysmal Jaw Clonus With Blepharospasm and Sialorrhea Associated With D2R Autoantibodies. Neurol Neuroimmunol Neuroinflamm 2022; 9:9/4/e1172. [PMID: 35459715 PMCID: PMC9199103 DOI: 10.1212/nxi.0000000000001172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
Objectives To extend the symptomatic spectrum of acute neurologic syndrome associated with dopamine-2 receptor (D2R) antibodies. Methods A 13-year-old adolescent boy was admitted to the Neurology Department with abnormal jaw movements. The initial evaluation included laboratory examinations of blood, chest radiography, brain MRI, EEG, and neuropsychologic tests. Serum and CSF samples were collected for immunologic studies. The clinical outcome of the patient was followed up for 18 months after the first hospitalization. Results Paroxysmal jaw clonus, blepharospasm, and sialorrhea were observed in the patient with a history of Tourette syndrome and obsessive–compulsive disease and with an acute neurologic syndrome associated with D2R antibodies. The symptoms responded to IV methylprednisolone (IVMP), relapsed twice during prednisone reduction, and, finally, improved after the combined treatment of IVMP and IV immunoglobulin. Discussion Recognizing paroxysmal jaw clonus (possibly with blepharospasm and sialorrhea) and considering the relationship between these episodes and D2R antibodies will be helpful in the early diagnosis and treatment of immune neurologic syndromes.
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Maramattom BV. Paroxysmal Dysarthria Ataxia-Tremor- Blepharospasm Syndrome in Bickerstaff Brainstem Encephalitis; A Variant of Paroxysmal Dysarthria Ataxia Syndrome. Neurol India 2022; 70:437-438. [PMID: 35263942 DOI: 10.4103/0028-3886.338658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Cocoș R, Raicu F, Băjenaru OL, Olaru I, Dumitrescu L, Popescu BO. CACNA1B gene variants in adult-onset isolated focal dystonia. Neurol Sci 2020; 42:1113-1117. [PMID: 33051750 PMCID: PMC7870633 DOI: 10.1007/s10072-020-04778-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 09/26/2020] [Indexed: 12/25/2022]
Abstract
Background Isolated focal dystonia (IFD) is a heterogeneous group of potentially invalidating movement disorders. The etiopathogenesis is complex, both genetic and environmental factors playing a role, but remains elusive. The CACNA1B gene codes for the N-type neuronal voltage-gated calcium channels CaV2.2, which may play a role in the development of some IFD. Methods We analyzed samples from the GENDYS cohort for mutations in CACNA1B gene, using targeted next-generation sequencing (NGS). Results The GENDYS cohort consists of 120 people with adult-onset IFD (cervical dystonia 47.5%, blepharospasm 47.2%, others 8.3%). Of these, 35% had subsequent topographical extension. Average age at onset was 42 and average disease durations 8 years. Targeted NGS revealed a novel frameshift mutation c.2291AGG > A, in exon 19, and a previously reported variant, c.6834T > G, in exon 47. Conclusion Our findings suggest that disease-causing mutations in CACNA1B gene may be involved in the development of some adult-onset IFD. To our knowledge, this is the first study that identified a disease-causing CACNA1B gene mutation in association with adult-onset IFD.
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Affiliation(s)
- Relu Cocoș
- Department of Medical Genetics, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
| | - Florina Raicu
- Department of Medical Genetics, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
- Francisc I. Rainer Anthropological Research Institute, Romanian Academy, 8 Eroii Sanitari Bld, 050474, Bucharest, Romania
| | - Ovidiu Lucian Băjenaru
- Department of Clinical Neurosciences, Colentina Hospital Neurology Division, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
- Ana Aslan National Institute of Geriatrics and Gerontology, 9 Căldărușani Str, 011241, Bucharest, Romania
| | - Iulia Olaru
- Department of Clinical Neurosciences, Colentina Hospital Neurology Division, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
- Department of Neurology, Colentina Clinical Hospital, 19-21 Stefan cel Mare Str, 020125, Bucharest, Romania
| | - Laura Dumitrescu
- Department of Clinical Neurosciences, Colentina Hospital Neurology Division, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania
- Department of Neurology, Colentina Clinical Hospital, 19-21 Stefan cel Mare Str, 020125, Bucharest, Romania
| | - Bogdan Ovidiu Popescu
- Department of Clinical Neurosciences, Colentina Hospital Neurology Division, Carol Davila University of Medicine and Pharmacy, 37 Dionisie Lupu Str, 020021, Bucharest, Romania.
- Department of Neurology, Colentina Clinical Hospital, 19-21 Stefan cel Mare Str, 020125, Bucharest, Romania.
- Laboratory of Ultrastructural Pathology, Victor Babeș National Institute of Pathology, 99-101 Splaiul Independentei Str, 050096, Bucharest, Romania.
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Osaki TH, Osaki MH, Garcia DM, Osaki T, Ohkawara L, Belfort R, Cruz AAV. Evaluation of botulinum toxin effects in hemifacial spasm patients: correlation between clinical rating scales and high-speed video system measurements. J Neural Transm (Vienna) 2020; 127:1041-1046. [PMID: 32232566 DOI: 10.1007/s00702-020-02183-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to compare the scores of two clinical rating scales and high-speed video system measurements obtained during spontaneous eyelid movements in hemifacial spasm (HFS) patients before and after treatment. Patients were evaluated before and 30 days after receiving treatment with onabotulinumtoxinA injections. Using a high-speed video system, the eyelid movements were recorded bilaterally for 3 min and the energy power generated by the upper eyelid during spontaneous eyelid movements was assessed before and after treatment. The scores of the Jankovic rating scale (JRS) and Hemifacial Spasm Grading System (HSGS) were also assessed before and after treatment. The authors studied 22 patients. Significant reduction in JRS and HSGS scores and in the energy generated by the upper eyelid was observed after treatment. A power spectrum of less than 23,000 was associated with JRS and HSGS scores less than 4 and 6.25, respectively and a power spectrum greater than or equal to 23,000 was associated with JRS and HSGS scores greater than or equal to 4 and 6.25, respectively (p < 0.0001 and p = 0.0025). Rating systems are easy to use, but they may exhibit limitations in sensitivity to assess differences between distinct disease patterns and between subtle differences in treatment responses. The high-speed video system permits a greater degree of accuracy, which allows for the assessment of differences in eyelid movement patterns and would permit better tailoring of treatment to patients. However, simpler devices employing this system would need to be developed, so that it could be used in clinical practice.
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Affiliation(s)
- Tammy H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
- Department of Ophthalmology, University of Santo Amaro, São Paulo, SP, Brazil
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil
| | - Midori H Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil.
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil.
| | - Denny M Garcia
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of S. Paulo/Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Teissy Osaki
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
- Osaki Clinics, R. Vergueiro, 2045 cj. 1009, São Paulo, SP, 04101-000, Brazil
| | - Lilian Ohkawara
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
| | - Rubens Belfort
- Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of Sao Paulo-EPM/UNIFESP, São Paulo, SP, Brazil
| | - Antonio Augusto V Cruz
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of S. Paulo/Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Lee SY, Lai SC. Clinical and Electrophysiological Analysis of Chronic Eyelid Twitching. Acta Neurol Taiwan 2017; 26:177-183. [PMID: 30315563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Nearly everyone had experience of eyelid twitching (ET) and most physicians think it is benign and self limited. Most neurologists consider it is a symptom rather a disease. However, sometimes ET persists longer and becomes bothersome in some cases, i.e. chronic ET (CET). CET was seldom discussed seriously and studied extensively. Few studies concerning of CET especially its electrophysiological features had been reported. The purposes of this study are to delineate its clinical features and electrophysiological characters of CET. In consequence by knowing its pathophysiology we can prove CET is a disease entity as minor form of facial nerve neuropathy. METHODS A retrospective study by reviewing medical charts of patients with facial twitching and have been received examinations of facial nerve latency and blink response. We defined CET as persisting of ET more than 2 weeks. We collected 142 patients, age from 12 to 73 years-old, 34 men and 108 women. The onset month and season, sex, abnormal side, and abnormal index (AI=abnormal side minus normal side/normal side) of several variables from electrophysiological study were compared between men and women of CET. RESULTS There was significant gender difference on CET. Women were more vulnerable than men (female to male: 3 to 1). CET tended to develop more in cold weather (61.27%). Half of CET cases demonstrated delayed or absent R2 response in blink reflex. And 45.8% cases had prolonged facial nerve latency (>5% side to side difference), with the rate higher in women (48.5% vs 38.2%). These two findings indicating conduction defect of facial nerve pathway in CET cases. CONCLUSION Although CET has been considered as a benign, transient, somewhat physiological phenomenon, our study may suggest it can be a disease entity with minor facial nerve neuropathy.
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[A review 24: blepharospasm and hemifacial spasm]. Nippon Ganka Gakkai Zasshi 2005; 109:667-80; quiz 681. [PMID: 16281875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Riabtseva AA, Gerasimenko MI, Savina MM, Filatova EV. [Electrostimulation and magnetic therapy in the treatment of accommodation cramp and in the prevention of progressive myopia in children and adolescents]. Med Tekh 2002:24-7. [PMID: 12506744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
The paper presents a procedure and results of use of electrostimulation, magnetic therapy, and electrophoresis during treatment for accommodation cramp and in the prevention of myopia in children and adolescents. Data that characterize the dynamics and stability of achieved results are given.
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Abstract
We reviewed the histories of 115 patients who had idiopathic dystonia and who were 21 years of age and younger at onset of symptoms and 472 patients with onset older than age 21. Patients with onset in the lower extremities tended to be younger at onset (mean age 8.4 years), have rapid spread of symptoms to other body parts, and to develop generalized dystonia. Patients with onset in the upper extremities tended to be older at onset (mean age 11.2 years) and were less likely to develop generalized dystonia, but were more likely to experience spread of symptoms many years after the disease began. Almost 20% of patients younger than age 22 began with torticollis, and 67% of these remained focal after a mean 14.9 years. In adults, dystonic symptoms remained focal in the majority, but approximately 15-30% of patients presenting with blepharospasm, torticollis, laryngeal or brachial dystonia eventually experienced dystonia outside the initially involved segment. Almost 50% of children and adolescents with dystonia reported a family history of dystonia, compared with approximately 10-13% of patients with torticollis, laryngeal or brachial dystonia. Less than 3% of patients with blepharospasm reported a family history of dystonia. There were only minor differences in the pattern of spread of dystonic symptoms between Jewish and non-Jewish patients. Although younger patients were more likely to report a family history of dystonia, patterns of spread were the same for familial and sporadic patients in the same age range.
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Affiliation(s)
- P Greene
- Dystonia Clinical Research Center, Columbia-Presbyterian Medical Center, New York, NY 10032, USA
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SCASSELLATISFORZOLINI G. OPERATION FOR BLEPHAROSPASM. Br J Ophthalmol 1964; 48:165-8. [PMID: 14193674 PMCID: PMC505933 DOI: 10.1136/bjo.48.3.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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PODOLSKY E. Functional blepharospasm. Eye Ear Nose Throat Mon 1960; 39:506-7. [PMID: 14433595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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PAUFIQUE L. [Treatment of essential blepharospasm]. Bull Soc Ophtalmol Fr 1958; 3:277-8. [PMID: 13561084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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SCHENK H. [Trial therapy of essential blepharospasm and contraction entropium with rhaetocaine]. Ophthalmologica 1958; 135:103-10. [PMID: 13517802 DOI: 10.1159/000303282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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FRIEDE R. [Studies on operative treatment of blepharospasm]. Klin Monbl Augenheilkd Augenarztl Fortbild 1958; 133:270-2. [PMID: 13599395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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FILIPPONE A. [Treatment of essential blepharospasm with subtotal myectomy of the orbicularis]. Boll Soc Med Chir Cremona 1957; 11:9-16. [PMID: 13471791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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NAMAN R. [Nasal reflex therapy in optic atrophy, blepharospasm accompanied by lacrimation]. Maroc Med 1957; 36:32. [PMID: 13407170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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MENNA F. [Action of a new drug, tolseron, on spontaneous oscillating nystagmus and on essential blepharospasm]. Rass Int Clin Ter 1956; 36:611-5. [PMID: 13389807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
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HENDERSON JW. Essential blepharospasm. Trans Am Ophthalmol Soc 1956; 54:453-520. [PMID: 13433788 PMCID: PMC1312648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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ROSS RT. Pallido-pyramidal disease. Can Med Assoc J 1955; 73:17-22. [PMID: 14390039 PMCID: PMC1825953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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FABING HD. Alpha-(2-piperidyl) benzhydrol hydrochloride, a new central stimulant, in the treatment of blepharospasm, spasmodic torticollis and narcolepsy; preliminary report. Trans Am Neurol Assoc 1954; 13:159-63. [PMID: 13238344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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MANCEAUX, JORDA, TIMSIT. [ Blepharospasm of comitial nature in oligophrenia; therapy of pneumoencephalography]. Rev Otoneuroophtalmol 1953; 25:236-8. [PMID: 13112903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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SUTTER JM, FOISSIN J. [ Blepharospasm and photophobia; psychosomatic studies]. Rev Otoneuroophtalmol 1953; 25:59-61. [PMID: 13075432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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SILIATO F. [Two cases of unilateral palpebral spasm; etiopathogenetic considerations]. Ann Ottalmol Clin Ocul 1952; 78:595-602. [PMID: 13008250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
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BRUGGER H. [Treatment of blepharospasm and photophobia in keratoconjunctivitis phylctaenulosa with 1% aureomycin ointment]. Tuberkulosearzt 1951; 5:590-1. [PMID: 14931561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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HONEK A, ZIZKA F. [Case of blepharospasm successfully treated by unilateral ramisection of the facial nerve]. Cas Lek Cesk 1951; 90:743-6. [PMID: 14839720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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LARMANDE MA, TOULANT M. [Degree of blepharospasm and photophobia during pithiatic and simulated blindness]. Rev Otoneuroophtalmol 1951; 23:44-5. [PMID: 14845418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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BARRE JA, ROHMER F, PHILIPPIDES D. [Three cases of favourable results of surgery in intense blepharospasm; comments on paradoxal behavior of the orbicularis of the eyelids]. Rev Neurol (Paris) 1950; 82:134-6. [PMID: 15441701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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GIVNER I, JAFFE NS. Myokymia of the eyelids; a suggestion as to therapy; preliminary report. Am J Ophthalmol 1949; 32:51-55. [PMID: 18106913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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RINTELEN F. [For the therapy of blepharospasm]. Schweiz Med Wochenschr 1948; 78:647. [PMID: 18934752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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CHAVANNE L. [ Blepharospasm and trismus of nasopharyngeal origin]. Otorhinolaryngolog Int 1947; 31:205-207. [PMID: 18904636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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MAZOW BJ. Method of taking impressions for contact lens patients with marked blepharospasm. Opt J Rev Optom 1947; 84:55. [PMID: 20254563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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CROOKES GP. Traumatic blepharospasm as an isolated symptom. Br Med J 1946; 1:486. [PMID: 20988606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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LIGHTWOOD R. Myelitis from mumps. Br Med J 1946; 1:484. [PMID: 20988604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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