John B. Holds

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The paralytic properties of botulinum A toxin have led to its use in humans in the treatment of strabismus and facial dystonias such as essential blepharospasm. Examination of orbicularis muscle from 10 patients with essential blepharospasm who received 2-18 injections of botulinum toxin 6 weeks to 3 years prior to surgery revealed characteristic nodal,(More)
To assess longstanding alterations in human muscle innervation induced by botulinum toxin, we studied motor axons in the orbicularis oculi of nine patients previously injected with botulinum toxin for treatment of benign essential blepharospasm (BEB). Compared with untreated BEB and normal orbicularis oculi, muscle exposed to botulinum toxin developed(More)
BACKGROUND Nonarteritic anterior ischemic optic neuropathy (NAION) is a common cause of visual loss in the older population. Bilateral NAION is a well-documented entity; however, no study to date has compared the visual outcome between affected eyes. METHODS The authors retrospectively reviewed the charts of 99 patients with diagnoses of NAION over 3 1/2(More)
Movement disorders, or dyskinesias, in the facial region may be categorized in several ways. Dystonic movement disorders in the cranial-cervical region, including essential blepharospasm, Meige syndrome and spasmodic torticollis, are characterized by uncontrollable squeezing movements in the face and neck. These disorders typically present in the fifth and(More)
The auditory brain-stem response (ABR) has been reported to detect abnormalities in both the auditory pathways and in adjacent structures. Ten of 35 consecutive patients with blepharospasm were found to have abnormal ABRs involving poor form and delayed peak latency of positive components III or V. Abnormal ABRs in approximately 30% of patients with(More)
BACKGROUND XCiDaBLE is a large, prospective, observational "naturalistic" study evaluating Xeomin® for Cervical Dystonia or BLEpharospasm in the United States. We report the interim results from the blepharospasm cohort of XCiDaBLE. METHODS Subjects (≧18 years old) with blepharospasm were followed for two treatment cycles of incobotulinumtoxinA and(More)
Combined medial canthotomy and cantholysis is a quick, technically simple, single-stage reconstructive technique for use in the reconstruction of the upper or lower eyelid. This technique, which transects one lacrimal canaliculus, provides up to 20% of the horizontal eyelid dimension for closure. Medial canthotomy and cantholysis is most frequently used in(More)
The eyes and periocular area are the central aesthetic unit of the face. Facial aging is a dynamic process that involves skin, subcutaneous soft tissues, and bony structures. An understanding of what is perceived as youthful and beautiful is critical for success. Knowledge of the functional aspects of the eyelid and periocular area can identify(More)
The upper eyelid serves the important anatomic function of protecting the eye and rewetting the cornea to maintain vision. The complex dynamic action of the upper eyelid explains its relatively complex anatomy. The brow has an important supportive role. Studies have revealed facial characteristics perceived as youthful and aged, and the anatomic basis of(More)
In essential blepharospasm histopathologic and electrophysiologic evidence supports the existence of lesions in proximity to brainstem nuclei controlling ocular movements. We studied horizontal ocular movements in eight patients who had been treated previously with surgery or botulinum toxin injection to control essential blepharospasm (mean age, 58 years)(More)
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