Blepharospasm With Basal Ganglia Lesions

Abstract

To the Editor. —In 1983, we were the first to suggest that blepharospasm may be associated with rostral brainstem-diencephalic lesions,¹ and, therefore, we found the report by Keane and Young² of a 31-year-old man with blepharospasm as a consequence of ischemia of the striatum to be extremely interesting. After our original series of six patients, we and others observed additional patients with an identifiable lesion in this area (Table).^3-8 One such patient was of particular interest. Report of a Case. —A 50-year-old man had had progressive parkinsonian symptoms for eight years. The most disabling findings were a coarse rest and action tremor, bradykinesia, and painful rigidity, more severe on the left side. Because the tremor was disabling and did not respond to anticholinergic or dopaminergic therapy, the patient underwent a right-sided thalamotomy in the nucleus ventralis intermedius on Jan 28, 1985, and a left-sided thalamotomy six months