Efficacy of Repetitive Transcranial Magnetic Stimulation Combined with Botulinum Toxin Type A for Benign Essential Blepharospasm Patients Accompanied by Anxiety and Depression

Objective: To evaluate the improvement of motor, anxiety, and depression in patients with blepharospasm with the use of botulinum toxin type A (BTX-A) and repetitive transcranial magnetic stimulation (rTMS). Methods: A total of 63 BEB patients accompanied by anxiety/depression were enrolled, among which 28 patients were treated with the injection of botulinum toxin type A (BTX-A) alone, while 35 patients were treated with BTX-A injection combined with rTMS. All patients were followed up for 6 months, and the overall efficacy was evaluated. Results: BTX-A alone treatment and combined rTMS treatment could both significantly improve the symptoms of patients, and the effective rate was 92.86% and 94.29%, respectively. The duration of efficacy was significantly longer in the combined rTMS treatment group (16.89 +/- 3.39 weeks) than in BTX-A treatment group (13.04 +/- 3.48 weeks). After treatment, SDS score of BTX-A treatment group and combined rTMS treatment group was 49.69 +/- 7.90 and 49.46 +/- 6.73, respectively, and there was no significant difference between the two treatment groups; SAS score of BTX-A treatment group and combined rTMS treatment group was 53.88 +/- 7.34 and 48.79 +/- 6.62, respectively, and there was significant difference between the two treatment groups. Conclusion: Compared to BTX-A alone treatment, BTX-A combined with rTMS can effectively improve the effect of BTX-A, prolong the duration of blepharospasm relief, and significantly reduce depression and anxiety in patients with BEB.