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Yıl:2004; Cilt: 7; Sayı: 1>> Özet
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Klinik Psikiyatri Dergisi; 2004;7(1):57-60
Blefarospazm, Tourette Sendromu ve Obsesif Kompulsif Bozukluk: İki olgu sunumu
PK Sayan, V Topçuoğlu, A Gımzal, EO Göktepe
Marmara Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalı, İstanbul
Blefarospazm orbikularis okuli kaslarının istemsiz kasılmalarıyla, gözkapaklarının sürekli veya aralıklı olarak kapandığı bir hareket bozukluğudur. Blefarospazm hastalarında, sağlıklı kontrollerle ve başka hareket bozukluğu hastalarıyla kıyaslandığında obsesif kompulsif belirtilerin daha sık görüldüğü bildirilmiştir. Bu yazıda, blefarospazmla obsesif kompulsif bozukluğun (OKB) birlikte görüldüğü iki olgu sunulmuştur. Olguların değerlendirilmesi sırasında, OKB yanında Tourette send­romu (TS) belirtilerinin de olduğu görülmüştür. TS ve OKB özellikle de çocukluk başlangıçlı OKB, yüksek oranda birliktelik gösterirler. Blefarospazmın, TS'de en sık rastlanan oftalmik patololoji olduğu bildirilmiştir. Beyin görüntüleme çalışmaları OKB'de bazal gangliyon yapılarının önemli bir rolü olabileceğini göstermektedir. Bilateral bazal gangliyon lezyonları sonrası ortaya çıkan obsesif kompulsif davranışlar bildirilmiştir. Blefarospazm genellikle idiopatiktir, ancak bazı olgular beyin sapı ya da bazal gangliyon lezyonlarıyla ilişkilidir. Bu OKB, TS ve blefarospazm şeklindeki psiko-nöro-oftalmik birlikteliğe her üç bozuklukta da bazal gangliyon disfonksiyonunun rol oynaması neden oluyor olabilir. Blefarospazm olgularında, TS'nin ve OKB'nin görülebileceği akılda tutulmalı ve hastalar bu açılardan değerlendirilmelidir.
Blepharospasm, Tourette Syndrome and Obsessive Compulsive Disorder: Two Case Reports
Blepharospasm is a movement disorder characterized by involuntary contractions of the orbicularis oculi muscles with continuous or intermittent eyelid closures. Obsessive compulsive symptoms are reported to be more frequent in patients with blepharospasm compared to healthy controls and patients with other movement disorders. In this paper, two cases of blepharospasm with obsessive-compulsive disorder (OCD) are presented. The assessment of the cases revealed that they had symptoms of Tourette syndrome (TS) as well as OCD. TS and OCD, especially childhood-onset OCD, can highly be seen together. Blepharospasm is the most common ophthalmic pathology in TS. The brain-imaging studies in OCD show that basal ganglia structures can play an important role in this disorder. Obsessive-compulsive behavior, which occurred after bilateral basal ganglia lesions, has been described. Blepharospasm is usually idiopathic, but some cases are associated with lesions in the brainstem or the basal ganglia. This psycho-neuro-ophtalmic combination, namely OCD, TS and blepharospasm, might be caused by the role of basal ganglia dysfunction in each of three disorders. It must be considered that TS and OCD may coexist in cases of blepharospasm and patients must be assessed in this point of view.

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