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Posted by: tatia ® 09/13/2013, 23:42:42 |
I was surprised to come across a term I'd never heard before: Charcot sign, or Charcot's sign. I didn't find it mentioned in the archives, either. Charcot's sign basically says that blepharospasm induces the lowering of the eyebrow down into the area of the eye socket. This could be helpful here when talking with the occasional newcomer who isn't yet diagnosed and might not have classic symptoms. Occasionally someone sounds like they are describing myokymia (the ripply twitches people get in their eyelids when they are tired, stressed, and over-caffeinated) instead of BEB. Or there is uncertainty between hemifacial spasm and an early case of BEB that hasn't yet gone bilateral. Apparently in HFS, the eyebrow usually goes *up.* So in either case, we can ask them what their eyebrow is doing. Peter and JudithK, I especially wanted to share this with you guys because you both seem interested and talented at this sort of thing. Forgive me if it's been discussed and I just missed it.
Another idea is that *pretarsal* BEB does NOT induce Charcot's sign. A neurologist who was trained to look for Charcot's sign might diagnose apraxia in its absence, when in reality, it could be pretarsal BEB. This is important when considering the likely effectiveness of Botox treatments.
Related link: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)71235-6/fulltext Modified by tatia at Fri, Sep 13, 2013, 23:47:48 |
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Posted by: In Indiana ® 09/15/2013, 06:03:28 |
Hi, Tatia-
Thanks for sharing this! I can only say that if someone mentions Charcot's sign to a health care provider, many different thoughts may go through their head. When I first started reading your post, I thought of Charcot foot, which I see as a severe complication of uncontrolled diabetes. I'd also heard of Charcot's artery, so I did a quick search. There are so many different medical signs/terms named after Charcot - it's hard to know what is what! Here's what I'm talking about: http://en.wikipedia.org/wiki/Charcot In recent years, thankfully diseases/symptoms have been named according to descriptions of what is going on instead of people's last names. I think the term "Charcot sign" relating to the eyebrow may be a bit confusing. In any case, I think it would be worth a trial of Botox no matter what if the patient is willing, with or without a positive Charcot's sign. I'm just trying to keep it simple... |
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Posted by: pdb ® 09/16/2013, 14:04:34 |
I'm more inclined to think this was the use of an outdated term, rather than anything profound. Similarly, if there were a significant difference between unilateral early BEB spasm appearance and HFS, one might have expected those researchers and practitioners who see these things frequently to have noted that. Interesting (as I read it) that they rely on emg to confirm apraxia. Peter |
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