# High Dose AbobotulinumtoxinA for Blepharospasm: A Case Report on the Safety and Efficacy of 500 Units of AbobotulinumtoxinA

## TL;DR

This case report shows that high doses of AbobotulinumtoxinA can safely and effectively treat severe blepharospasm when standard doses fail.

## Contribution

Demonstrates the safety and efficacy of high-dose AbobotulinumtoxinA in managing refractory blepharospasm over multiple treatment cycles.

## Key findings

- Two patients achieved sustained symptomatic relief with 500 units of AbobotulinumtoxinA every 12 weeks.
- Adverse effects were mild and transient, supporting the safety of high-dose treatment.
- High-dose AbobotulinumtoxinA may be effective for patients not responding to standard doses.

## Abstract

Blepharospasm is a focal dystonia characterized by involuntary eyelid closure that can impair vision and quality of life. Botulinum neurotoxin type A injections are the standard treatment. However, there is substantial variability in dose requirements among patients. Symptom severity ranges from mild, intermittent blinking to forceful, sustained spasms leading to functional blindness.

We present two cases of blepharospasm successfully managed with unusually high doses of AbobotulinumtoxinA administered over 8 and 13 treatment cycles, respectively.

Both patients achieved sustained symptomatic relief with only mild, self-limiting side effects, underscoring the importance of individualized dosing strategies in clinical practice.

Two patients with refractory blepharospasm were successfully managed with high-dose AbobotulinumtoxinA (500 U every 12 weeks)Both patients achieved sustained symptomatic improvement over multiple treatment cyclesAdverse effects were mild and transientHigh-dose AbobotulinumtoxinA may represent a safe and effective option for patients inadequately controlled with standard doses

Two patients with refractory blepharospasm were successfully managed with high-dose AbobotulinumtoxinA (500 U every 12 weeks)

Both patients achieved sustained symptomatic improvement over multiple treatment cycles

Adverse effects were mild and transient

High-dose AbobotulinumtoxinA may represent a safe and effective option for patients inadequately controlled with standard doses