Blepharospasm in a Multiethnic Population (P3.348)

Objective: To determine the incidence of dystonic blepharospasm and characterize antecedent diagnoses within a large, multiethnic integrated health maintenance organization. Background: There are limited data on blepharospasm incidence and prior reports have been based on a small number of cases. Design/methods: Incident blepharospasm cases were identified using electronic medical record review in >3 million members of Kaiser Permanente Northern California (KPNC) during 2003-2007. Final diagnosis was determined by consensus of two movement disorders specialists. Incidence rates were standardized using the 2000 U.S. Census population. Controls were matched for age, sex and membership duration (1 case: 10 controls). Odds ratios were determined using logistic regression adjusted for age, gender and membership duration. Results: Blepharospasm incidence standardized to the U.S. 2000 Census population was 1.45/100,000 person-years (95[percnt] CI, 0.53 to 2.37; women: 2.05, men: 0.83) based on 246 cases over 15.4 million person-years of risk. Incidence increased with age through the eighth decade and was highest in Caucasians (1.58) followed by Asians (1.32), African Americans (1.08) and Native Americans (0.95). Ocular diagnoses more common in patients with blepharospasm compared to controls before index date included were eye allergy (OR 2.82, 95[percnt] CI, 1.69 to 4.7), dry eyes (OR 9.19, 95[percnt] CI, 6.22 to 13.58), glaucoma (OR 2.76, 95[percnt] CI, 1.28 to 5.95), eye injury (OR 2.38, 95[percnt] CI, 1.44 to 3.94) and eye infection (OR 3.76, 95[percnt] CI, 2.58 to 5.47). Conclusions: Blepharospasm incidence is higher in women, in those of increasing age and of Caucasian race. Diagnoses preceding blepharospasm may reflect comorbid conditions, diagnostic errors or etiologic factors. Support: NIH-1R01-NS046340, AHRQ-R01-HS018413, Dystonia Medical Research Foundation, KPNC, James and Sharron Clark Disclosure: Dr. Byrd has nothing to disclose. Dr. Albers has nothing to disclose. Dr. Goldman has nothing to disclose. Dr. Klingman has nothing to disclose. Dr. Lo has nothing to disclose. Dr. Marras has nothing to disclose. Dr. Leimpeter has nothing to disclose. Dr. Fross has nothing to disclose. Dr. Comyns has nothing to disclose. Dr. Gu has nothing to disclose. Dr. Katz has nothing to disclose. Dr. Ozelius has nothing to disclose. Dr. Bressman has nothing to disclose. Dr. Saunders-Pullman has nothing to disclose. Dr. Comella has received personal compensation for activities with Ipsen, Merz, Allergan, Medtronic, Teva, US World Meds, Impax, Acadia, Acorda, Revance, Neurocrine, and Ultragenx Pharmaceuticals as a consultant. Dr. Comella has received research support Dr. Nelson has received compensation from Neuropace Inc. for service on a DSMB, and from Acumen, LLC for epidemiology consulting. Dr. Van Den Eeden has nothing to disclose. Dr. Tanner has received personal compensation for activities with Neurocrine and Ultragenyx Pharmaceuticals as a consultant.