Blepharospasm Bulletin Board

June, thanks for searching the Archives, producing the study of sites & dosages, & bleph sites used by ophths & neuros.

Peter, the video is approx 27 mins long, as you know, & the 3rd part is said to be the injection technique section, a ways into the video. I have broadband & alot of buffering & it will take awhile to view, but I shall.

The neuro I've been going to for years has, during the last 2 treatments, administered the shots in a very painful way, resulting in immediate copious tears (on my part!) as a reflex .

I had never minded the previous treatments, being accustomed to the brief momentary punctures, so I wondered about the variables with this dramatic change in pain level.

The dosages & sites & needle gauge have been the same & worked wonderfully.

His technique hasn't changed, I sit on a chair & he stands over me & reaches over & down.
I had previously asked him if he ever did the shots while the patient lies on the gurney in the office, as a previous neuro had done to totally pain-free effect.
He said no, because he thinks standing helps him control the symmetry. I mentioned that the gurney technique resulted in symmetry.
I asked him if he ever sits on a stool, right next to the patient. (I'd heard that is Dr. Miller's technique.) He said no.

So all the variables were the same for the last 2 visits, but resulting in great pain, & I'm not exaggerating, nor do I by any means wish to discourage anyone from injections.

So I question his angle of injections. He does not do surgery, so he does not have a surgeon's delicate dexterity. Tho I'm sure many neuros do.

So he stands up, in front of me, rather than to my side, so there is a greater distance than if he were to at least stand to my side, as I could easily turn my head sideways to accomodate his posture.

Judith, your comment about a lateral angle might be a clue, would that be a 45 degree angle?

Again, I vaguely remember some discussion about the efficacy of subcutaneous vs. intramuscular depth, but I could be way off about that, & any relevance.

BTW, coincidence or not, my last 2 painful treatments resulted in very poor spasm relief.
The semi-good effects lasted just a few weeks, whereas my previous 90-day cycles were always successful, more or less.