Evidence map›Paper›PMID 35716653›Full record

ArticleJournal of the neurological sciences2022

Diagnosis and classification of blepharospasm: Recommendations based on empirical evidence.

Gamze Kilic-Berkmen, Giovanni Defazio, Mark Hallett, Alfredo Berardelli, Gina Ferrazzano, Daniele Belvisi, Christine Klein, Tobias Bäumer, Anne Weissbach, Joel S Perlmutter and 3 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Journal of the neurological sciences, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. An Exploratory, Randomized, Double-Blind Clinical Trial of Dipraglurant for Blepharospasm.Movement disorders : official journal of the Movement Disorder Society · 2024
    Trial
  2. Article
  3. Article
  4. Definition and Classification of Dystonia.Movement disorders : official journal of the Movement Disorder Society · 2025
    Review
  5. Article
  6. Article
  7. What Is Hemidystonia?Movement disorders clinical practice · 2023
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 3 countries.

Gamze Kilic-BerkmenDepartment of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Giovanni DefazioDepartment of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Mark HallettHuman Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.
Alfredo BerardelliDepartment of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077 Pozzilli, Italy.
Gina FerrazzanoDepartment of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.
Daniele BelvisiDepartment of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077 Pozzilli, Italy.
Christine KleinInstitute of Neurogenetics and Department of Neurology, University of Luebeck, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
Tobias BäumerInstitute of System Motor Science, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
Anne WeissbachInstitute of Neurogenetics and Department of Neurology, University of Luebeck, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Institute of System Motor Science, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
Joel S PerlmutterDepartment of Neurology, Radiology, Neuroscience, Physical Therapy and Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA.
Jeanne FeuersteinDepartment of Neurology, University of Colorado, Aurora, CO, USA.
H A JinnahDepartment of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: hjinnah@emory.edu.
Dystonia Coalition Investigators
Sapienza University of Rome · ITEmory University · USUniversity of Lübeck · DENational Institute of Neurological Disorders and Stroke · USUniversity Hospital Schleswig-Holstein · DEUniversity of Cagliari · ITUniversity of Colorado Anschutz Medical Campus · USWashington University in St. Louis · US

Funding

Pathophysiology of Basal Ganglia DisordersZIANS003031 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI HALLETT, MARK · 2009 to 2023
$22.7M
INVESTIGATIONS OF DEMENTIA IN PARKINSON DISEASER01NS075321 · NINDS · WASHINGTON UNIVERSITY · PI CAMPBELL, MEGHAN C, PERLMUTTER, JOEL SYNES · 2011 to 2021
$8.2M
Dystonia Coalition- Pilot ProjectU54NS116025 · NINDS · EMORY UNIVERSITY · PI JINNAH, HYDER A · 2019 to 2023
$7.1M
Dystonia CoalitionU54NS065701 · NINDS · EMORY UNIVERSITY · PI JINNAH, HYDER A · 2009 to 2014
$7.0M
Dystonia CoalitionU54TR001456 · NCATS · EMORY UNIVERSITY · PI JINNAH, HYDER A · 2015 to 2016
$2.5M
Investigations of Dementia in Parkinson DiseaseRF1NS075321 · NINDS · WASHINGTON UNIVERSITY · PI CAMPBELL, MEGHAN C, PERLMUTTER, JOEL SYNES · 2023 to 2023
$2.3M
Deep phenotyping in blepharospasmR01NS119831 · NINDS · EMORY UNIVERSITY · PI JINNAH, HYDER A, YEO, WOON-HONG · 2021 to 2024
$1.5M
NCATS NIH HHS U54 TR001456NINDS NIH HHS R01 NS075321NINDS NIH HHS R01 NS119831NINDS NIH HHS RF1 NS075321NINDS NIH HHS U54 NS065701NINDS NIH HHS U54 NS116025
6 · The paper itself

Abstract

backgroundBlepharospasm is one of the most common subtypes of dystonia, and often spreads to other body regions. Despite published guidelines, the approach to diagnosis and classification of affected body regions varies among clinicians.

objectiveTo delineate the clinical features used by movement disorder specialists in the diagnosis and classification of blepharospasm according to body regions affected, and to develop recommendations for a more consistent approach.

methodsCross-sectional data for subjects diagnosed with all types of isolated dystonia were acquired from the Dystonia Coalition, an international, multicenter collaborative research network. Data were evaluated to determine how examinations recorded by movement disorder specialists were used to classify blepharospasm as focal, segmental, or multifocal.

resultsAmong all 3222 participants with isolated dystonia, 210 (6.5%) had a diagnosis of focal blepharospasm. Among these 210 participants, 34 (16.2%) had dystonia outside of upper face region. Factors such as dystonia severity across different body regions and number of body regions affected influenced the classification of blepharospasm as focal, segmental, or multifocal.

conclusionsAlthough focal blepharospasm is the second most common type of dystonia, a high percentage of individuals given this diagnosis had dystonia outside of the eye/upper face region. These findings are not consistent with existing guidelines for the diagnosis and classification of focal blepharospasm, and point to the need for more specific guidelines for more consistent application of existing recommendations for diagnosis and classification.

Indexed as

BlepharospasmDystoniaDystonic DisordersCross-Sectional StudiesHumansBlepharospasmCraniofacial dystoniaMeige syndrome

Identifiers

PMID35716653
PMCPMC9357089
OpenAlexW4281705341

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.