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      Epidemiology of benign essential blepharospasm: A nationwide population-based retrospective study in Taiwan

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          Abstract

          Importance

          This study provides a nationwide, population-based data on the incidence of benign essential blepharospasm in Asian adults.

          Background

          To describe the incidence, patient demographics, and risk factors associated with benign essential blepharospasm.

          Design

          Population-based retrospective study.

          Participants and samples

          A total of 1325 patients with benign essential blepharospasm were identified.

          Methods

          Patients with diagnosis of blepharopsasm between January 2000 and December 2013 were sampled using the Longitudinal Health Insurance Database 2000. Secondary blepharospasm that may be related to neurological, trauma, and ocular surface disease were excluded.

          Main outcome measured

          Multivariate conditional logistic regression was used to estimate the odds ratios for potential risk factors of benign essential blepharospasm.

          Results

          The mean annual incidence was 0.10‰ (0.07‰ for males, and 0.12‰ for females). The peak incidence was in the 50 to 59-year-old age group (0.19‰). People living in urban regions have more risk of developing blepharospasm comparing to people living in less urban regions (p <0.01). White-collar workers also have higher chance of having blepharospasm (p<0.001). Significant difference between control group and case group in hyperlipidemia (p <0.001), sleep disorders (p <0.001), mental disorders (depression, anxiety, obsessive compulsive disorder) (p <0.001), dry eye-related diseases (dry eye, Sjögren’s syndrome) (p <0.001), Parkinson’s disease (p <0.004), and rosacea (p <0.021) were also identified.

          Conclusions and relevance

          Higher level of urbanization, white-collar work, sleep disorders, mental health diseases, dry eye-related diseases, Parkinsonism, and rosacea are possible risk factors for benign essential blepharospasm.

          Related collections

          Most cited references44

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          The focal dystonias: current views and challenges for future research.

          The most common forms of dystonia are those that develop in adults and affect a relatively isolated region of the body. Although these adult-onset focal dystonias are most prevalent, knowledge of their etiologies and pathogenesis has lagged behind some of the rarer generalized dystonias, in which the identification of genetic defects has facilitated both basic and clinical research. This summary provides a brief review of the clinical manifestations of the adult-onset focal dystonias, focusing attention on less well understood clinical manifestations that need further study. It also provides a simple conceptual model for the similarities and differences among the different adult-onset focal dystonias as a rationale for lumping them together as a class of disorders while at the same time splitting them into subtypes. The concluding section outlines some of the most important research questions for the future. Answers to these questions are critical for advancing our understanding of this group of disorders and for developing novel therapeutics. © 2013 Movement Disorder Society.
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            Epidemiology of focal and generalized dystonia in Rochester, Minnesota.

            The epidemiology of generalized and focal dystonias was investigated in the Rochester, Minnesota, population over the period 1950-1982. The crude incidence of generalized dystonia was 2 per million persons per year, and for all focal dystonias combined, 24 per million per year. The crude prevalence rate was 34 per million persons for generalized dystonia and 295 per million persons for all focal dystonias. Torticollis was the most common focal dystonia; essential blepharospasm, oromandibular dystonia, spasmodic dysphonia, and writer's cramp were less common and had roughly equal incidence and prevalence rates.
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              A prevalence study of primary dystonia in eight European countries.

              There have been few epidemiological studies of dystonia. Most previous studies have provided estimates based on few cases. A European prevalence study was undertaken to provide more precise rates of dystonia by pooling data from eight European countries. Diagnosed cases were ascertained by adult neurologists with specialist movement disorder (and botulinum toxin) clinics. The crude annual period prevalence rate (1996-1997) for primary dystonia was 152 per million (95% confidence interval 142-162), with focal dystonia having the highest rate of 117 per million (108-126). Prevalence rates for cervical dystonia, blepharospasm and writer's cramp were as follows: 57 (95% confidence interval 51-63), 36 (31-41), and 14 (11-17). The age-adjusted relative rates were significantly higher in women than in men for segmental and focal dystonias with the exception of writer's cramp. Comparing rates between centres demonstrated significant variations for cervical dystonia, blepharospasm and writer's cramp, probably due to methodological differences. Our results provide the first data on the prevalence of primary dystonia and its subtypes across several European countries. Due to under-ascertainment of cases, our rates should be seen as conservative and an under-estimate of the true prevalence of dystonia.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Software
                Role: ConceptualizationRole: Project administration
                Role: Investigation
                Role: ConceptualizationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 December 2018
                2018
                : 13
                : 12
                : e0209558
                Affiliations
                [1 ] Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
                [2 ] Kaohsiung Medical University of Hospital, Kaohsiung, Taiwan
                [3 ] Rong Xin Mental Health Clinic, Kaohsiung, Taiwan
                [4 ] Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
                [5 ] Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan
                [6 ] School of Medicine, National Yang-Ming University, Taipei, Taiwan
                [7 ] Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan
                [8 ] National Defense Medical Center, Taipei, Taiwan
                University of Cagliari, ITALY
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-7020-5296
                Article
                PONE-D-18-09919
                10.1371/journal.pone.0209558
                6306223
                30586395
                e6a924ea-cb70-491a-b1fe-311a074d4f90
                © 2018 Sun et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 3 April 2018
                : 9 December 2018
                Page count
                Figures: 2, Tables: 5, Pages: 14
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Medicine and Health Sciences
                Neurology
                Sleep Disorders
                Medicine and Health Sciences
                Neurology
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Medicine and Health Sciences
                Diagnostic Medicine
                Signs and Symptoms
                Hyperlipidemia
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Signs and Symptoms
                Hyperlipidemia
                Medicine and Health Sciences
                Neurology
                Neurodegenerative Diseases
                Movement Disorders
                Dystonia
                Biology and Life Sciences
                Anatomy
                Head
                Eyes
                Medicine and Health Sciences
                Anatomy
                Head
                Eyes
                Biology and Life Sciences
                Anatomy
                Ocular System
                Eyes
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Eyes
                Medicine and Health Sciences
                Ophthalmology
                Eye Diseases
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Custom metadata
                All relevant data are within the manuscript.

                Uncategorized
                Uncategorized

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