Treatment of Essential Blepharospasm-Reply

In Reply.—The use of a standardized and objective method for the evaluation of the results obtained with surgical treatment of facial hyperkinesia would be, as Dr Popp pertinently points out, very desirable. However, all facial hyperkinetic movements vary over time and affect the patient in such different ways that, after all, it still seems reasonable to have the patient determine the percentage of relief of spasm obtained postoperatively.We were not aware of the article by Frueh and coworkers (see reference 3, above) on the effects of differential section of the seventh nerve on patients with untreatable blepharospasm: 80% to 86% of the patients believed they were significantly improved after surgery. These figures compare very favorably with the number of patients having their spasm relieved 50% or more in our own results. The sample applies for the minimal secondary side effects of selective neurectomy. However, many surgeons familiar with