Journal of Emergency Medicine Case Reports

2149-9934

Acil Tıp Uzmanları Derneği

10.33706/jemcr.550841

Blepharospasm induced by systemic isotretinoin

Gülhan Gürel

Gülhan

Sacmacı

Hikmet

04 01 2019

10 2 33 35 03 08 2018

2010

Journal of Emergency Medicine Case Reports

Introduction:Isotretinoin(13-cis-retinoic acid), a synthetic analog of vitamin A, is commonly used inthe treatment of nodulocytic acne, which is resistant to other treatments. Themost common side effects of systemic isotretinoin treatment are dry mucousmembranes and dry skin. Blepharospasm is a movement disorder characterized byhyperactivity of orbicularis oculi and other muscles around the eye.CaseReport: We report here  a 33-year-oldfemale patient developed blepharospasm during treatment with systemicisotretinoin. She consulted an ophthalmologist about her eye problem and wasdiagnosed as having ‘dry eye’. Blepharospasm did not improve even though shereceived artificial tears treatment. Magnetic resonance imaging and magneticresonance angiography were performed to investigate the etiology ofblepharospasm and no pathological findings were found.Conclusion:Wepresent a case of blepharospasm due to isotretinoin. Based on PubMed database,this is the first clinical case of blepharospasm induced by isotretinoin. 

Blepharospasm isotretinoin

1. Demirseren DD, Kilinc F, Emre S, Akyol M, Metin A, Aktas A. The weeks and the cumulative doses of the first adverse events related to oral isotretinoin in acne patients: analysis of 300 patients. J Dermatolog Treat. 2017;28:309-313.

2. Brzezinski P, Borowska K, Chiriac A, Smigielski J. Adverse effects of isotretinoin: A large, retrospective review. Dermatol Ther. 2017;30(4).

3. Moy A, McNamara NA, Lin MC. Effects of Isotretinoin on Meibomian Glands. Optom Vis Sci. 2015;92:925-930.

4. Defazio G, Hallett M, Jinnah HA, Conte A, Berardelli A. Blepharospasm 40 years later. Mov Disord. 2017;32:498-509.

5. Emoto Y, Emoto H, Oishi E, Hikita S, Wakakura M. Twelve cases of drug-induced blepharospasm improved within 2 months of psychotropic cessation. Drug Healthc Patient Saf. 2011;3:9-14.

6. Khooshnoodi MA, Factor SA, Jinnah HA. Secondary blepharospasm associated with structural lesions of the brain. J Neurol Sci. 2013;331:98-101.

7. Kiliç A, Erten E, Özdemir A. Tardive Blepharospasm and Meige Syndrome during Treatment with Quetiapine and Olanzapine. Noro Psikiyatr Ars. 2015;52:207-209.

8. Suzuki Y, Kiyosawa M, Wakakura M, Mochizuki M, Ishiwata K, Oda K, et al. Glucose hypermetabolism in the thalamus of patients with drug-induced blepharospasm. Neuroscience. 2014;263:240-249.

9. Neudorfer M, Goldshtein I, Shamai-Lubovitz O, Chodick G, Dadon Y, Shalev V. Ocular adverse effects of systemic treatment with isotretinoin. Arch Dermatol. 2012;148:803-808.

10. Valls-Sole J, Defazio G. Blepharospasm: Update on Epidemiology, Clinical Aspects, and Pathophysiology. Front Neurol. 2016;7:45.