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Invited Commentary
November 2016

Alleviating Maneuvers for Benign Essential Blepharospasm and Hemifacial Spasm

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston
  • 2Blanton Eye Institute, Department of Ophthalmology, Houston Methodist Hospital, Houston, Texas
  • 3Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, Houston, Texas
  • 4University of Texas MD Anderson Cancer Center, Houston, Texas
  • 5Baylor College of Medicine, Houston, Texas
  • 6Neuro-Ophthalmology Unit, Wilmer Eye Institute, and Departments of Ophthalmology, Neurology, and Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, Maryland
JAMA Ophthalmol. 2016;134(11):1253-1254. doi:10.1001/jamaophthalmol.2016.2983

In this issue of JAMA Ophthalmology, Kilduff et al1 report the largest published observational series to date of the use of alleviating maneuvers by patients with benign essential blepharospasm (BEB) or hemifacial spasm (HFS). The authors found that 39 of 74 patients with BEB (52.7%) and 25 of 56 patients with HFS (44.6%) used alleviating maneuvers, and that, of these patients, 64.8% of the patients with BEB and 45.8% of the patients with HFS reported that the alleviating maneuvers either abolished or reduced the symptoms of dystonia by at least 50%. Prior studies2,3 have shown similar results; for example, Loyola et al2 reported common sensory tricks such as facial massage among 60% of patients with HFS and touching the upper eyelid with the index finger and thumb among 81.8% of patients with BEB, and Ramos et al3 reported a long list of different maneuvers used by such patients. The study by Kilduff et al1 confirms the findings of these and other studies but also reports the novel finding that the use of alleviating maneuvers by patients with BEB or HFS correlates strongly with disease severity.