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2019 | 6 | 1 | 43-50
Article title

Kurcz powiek – od rozpoznania do właściwego leczenia

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EN
Blepharospasm – from diagnosis to proper treatment
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PL
Abstracts
EN
Background: Blepharospasm is a movement disorder characterized by involuntary spasms of eye-closing muscles. This second most common adult-onset focal dystonia still raises many doubts among ophthalmologists and neurologists. Aim of the study: To present current knowledge about blepharospasm with historical background of the disease. Methods: Literature review regarding diagnosis, pathophysiology and treatment of blepharospasm. Results: Different types of eye-closing spasms, the spread of dystonia, co-occurrence of eyelid opening apraxia, enhanced blinking, sensory trick and psychiatric disorders define blepharospasm as a heterogeneous condition. Actual genetic, electrophysiological and neuroimaging studies reveal complex and multifocal involuntary movements generators defining blepharospasm and other focal dystonias as a ”communication node disorders” where botulinum toxin acting at the end of all pathways is the first-line treatment. Conclusions: The history of blepharospasm as a neurological condition that affects the eye shows that the most important discoveries regarding the diagnosis, pathophysiology and treatment of this disease have occurred owing to ophthalmologists and neurologists. Therefore, the future of blepharospasm will also depend on this cooperation
PL
Wprowadzenie: Kurcz powiek (blepharospasm) jest zaburzeniem ruchowym charakteryzującym się mimowolnym skurczem mięśni zamykających oczy. Ta druga co do częstości dystonia ogniskowa występująca w wieku dorosłym wciąż budzi wiele wątpliwości zarówno wśród okulistów, jak i neurologów. Cel: Przedstawienie aktualnej wiedzy na temat kurczu powiek na tle rysu historycznego choroby. Metody: Przegląd literatury dotyczącej rozpoznania, patofizjologii i leczenia kurczu powiek. Wyniki: Różne typy skurczów mięśni zamykających oczy, rozprzestrzenianie się dystonii na dolną część twarzy i szyję, współwystępowanie apraksji otwierania powiek, częstego mrugania, trików czuciowych oraz zaburzeń psychiatrycznych definiują kurcz powiek jako heterogenną jednostkę chorobową. Aktualne badania genetyczne, elektrofizjologiczne i neuroobrazowe przynoszą wiedzę na temat złożonych i wieloogniskowych generatorów ruchów mimowolnych definiujących kurcz powiek wraz z innymi dystoniami ogniskowymi jako „chorobę węzła komunikacyjnego”, w której toksyna botulinowa działająca na końcu wszystkich ścieżek patologicznych jest leczeniem z wyboru. Wnioski: Historia kurczu powiek jako choroby neurologicznej dotykającej narządu wzroku pokazuje, że najważniejsze odkrycia dotyczące rozpoznania, patofizjologii oraz leczenia tej choroby miały miejsce zarówno dzięki okulistom, jak i neurologom. Dlatego przyszłość opisywanej choroby również będzie zależała od tej współpracy.
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Journal
Year
Volume
6
Issue
1
Pages
43-50
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References
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