右美沙芬治疗特发性眼睑痉挛的回顾性分析 A Retrospective Study on the Therapeutic Effect of Dextromethorphan on Essential Blepharospasm

背景：眼睑痉挛是一种局限性肌张力障碍，患者眼睛周围的肌肉频繁不自主收缩导致眼睑闭合和视力障碍。目前治疗眼睑痉挛的效果并不是很理想。本文是一项右美沙芬对眼睑痉挛疗效的回顾性研究。方法：回顾性研究包括22例特发性眼睑痉挛，患者接受右美沙芬治疗，30mg 每天三次口服，采用扬科维奇评分(Jankovic Rating Scale, JRS)和眼睑痉挛的残疾指数(Blepharospasm Disability Index, BSDI)评价疗效。结果：右美沙芬治疗前基线JRS评分是5.55±1.10分，BSDI基线评分为2.87±0.59。右美沙芬治疗1周后，JRS评分下降到2.82 ± 0.85分，BSDI下降到1.36 ± 0.58分。在接下来的3周的治疗，JRS和BSDI得分保持在一个稳定的状态。停止右美沙芬治疗一周后，JRS评分(5.41 ± 1.01分)和BSDI评分(2.63 ± 0.64分)回到治疗前的基线水平。结论：本研究发现右美沙芬对眼睑痉挛患者有效，这一发现可能意味着另一种治疗选项。 Background: Blepharospasm is a focal dystonia characterized by intermittent or continual invo-luntary contractions of the facial muscles around both eyes. It causes frequent eyelid closure and visual disturbance. The current therapies for blepharospasm are not satisfactory. Here is a retrospective study to analyze the therapeutic effect of dextromethorphan on blepharospasm. Methods: This retrospective study included 22 patients with blepharospasm. They were treated with dextromethorphan, 30 mg orally three times a day for 4 weeks. The effect of dextromethorphan on essential blepharospasm was evaluated using Jankovic Rating Scale (JRS) and Blepharospasm Disability Index (BSDI). Results: Before treatment, the baseline JRS score was 5.55 ± 1.10 points, and the BSDI score was 2.87 ± 0.59 points. After 1 week of dextromethorphan treatment, the JRS score decreased to 2.82 ± 0.85 points and the BSDI score to 1.36 ± 0.58 points. In the following 3 weeks of dextromethorphan treatment, the JRS and BSDI scores kept in a steady state. One week after the dextromethorphan treatment, the JRS (5.41 ± 1.01 points) and BSDI (2.63 ± 0.64 points) scores returned to the pre-treatment baseline level. Conclusion: We found that dextromethorphan is effective to relieve the symptoms in patients with blepharospasm, and this finding might imply an alternative treatment option to essential blepharospam.