Cognitive Function Evaluation by Mini- Mental State Examination-Korea in Essential Blepharospasm

Sok Joong Chung; Helen Lew

doi:10.3341/jkos.2013.54.6.857

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Chung and Lew: Cognitive Function Evaluation by Mini- Mental State Examination-Korea in Essential Blepharospasm

Original Article

J Korean Ophthalmol Soc 2013;54(6):857-861.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.6.857

Cognitive Function Evaluation by Mini- Mental State Examination-Korea in Essential Blepharospasm

Sok Joong Chung, MD, Helen Lew, MD

Department of Ophthalmology, Bundang CHA Medical Center, CHA University, Seongnam, Korea

Address reprint requests to Helen Lew, MD Department of Ophthalmology, Bundang CHA Medical Center #351 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea Tel: 82-31-780-5330, Fax: 82-31-780-5333, E-mail: eye@cha.ac.kr

Received 22 September 20121 November 2012 Accepted 13 March 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The present study evaluated cognitive functions of Korean patients with essential blepharospasm by the Mini Mental State Examination - Korea (MMSE-K).

Methods

Atotal of 33 patients diagnosedwith essential blepharospasm were evaluated. Using the K-MMSEcognitive functions such as orientation, registration and recall, attention and calculation, language, comprehension, and decision were evaluated.

Results

All patients were alert and orientedwith an average K-MMSEscore of 25.2 ± 4.0 points. The normal group scores were above 24 points in 25 patients (75%), suspected dementia scores were from 20 to 23 points in 5 patients (15%), and definite dementia scores were from 15 to 19 points in 3 patients (9%). Neurologic and brain imaging evaluation was performed in the 8 patients with suspected dementia or definite dementia. Among these patients, 2 were diag-nosed with Parkinson’s disease, 2 were shown to have a specific brain lesion on magnetic resonance imaging, and 1 was diagnosed with a stroke and treated with antiplatelet therapy.

Conclusions

The K-MMSE can be a helpful tool for the early detection of cognitive dysfunction in outpatients with es-sential blepharospasm.

Keywords: Cognitive function, Essential blepharospasm, Mini mental state examination

References

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Table 1.

Jankovic rating scale

Severity	0	None
	1	Increase in blinking present only with external stimuli (ex, bright light, wind, reading, etc)
	2	Mild, but spontaneous eyelid fluttering, definitely noticeable, possibly embarrassing, but not functionally disabling
	3	Moderate, very noticeable spasm of eyelids only, mildly incapacitating
	4	Severe, incapacitating spasm of eyelids and possibly other facial muscles
Frequency	0	None
	1	Slighty increased frequency of blinking
	2	Eyelid fluttering lasting less than 1 second in duration
	3	Eyelid spasm lasting more than 1 second, but eye open more than 50% of waking time
	4	Functionally “blind” due to persistent blepharospasm more than 50% of waking time

Table 2.

The demographic findings of the Patients with scoreslower than 23 evaluated by MMSE-K (Mini Mental State Examination-Korea)

Patients	Age	Sex	Score	Brain imaging
#1	72	F	21	Brain MRI	Non -specific abnormality
#2	62	F	23	PET	Symmetrically decreased radiotracer uptake in bilateral basal ganglia, especially lentiform nuclei
#3	68	F	23	Brain CT	Non -specific abnormality
#4	77	F	22	PET	Symmetrically decreased radiotracer uptake in bilateral basal ganglia, especially lentiform nuclei
#5	79	F	22	Brain MRI	Focal old infarcts at right basal ganglia and bilateral cerebellar hemispheres
#6	87	F	15	Brain CT	Diffuse senile brain atrophy
#7	76	F	15	Brain MRI	Non -specific abnormality
#8	78	F	17	Brain MRI	Old infarction in cerebellum

Table 3.

Difference of Age, Duration, and Botulinum toxin-A injection responses in the normal group and abnormal groupaccording to the MMSE-K (Mini Mental State Examination - Korea) Score

MMSE-K Score	Age (years)	Duration (years)	BoNT-A^* response	Orientation	Registration & recall	Attention & calculation	Language	Comprehension & decision
≤23 (n = 8)	74.1 ± 7.4	4.0 ± 4.2	6.0 ± 0.8	7.3 ± 2.4	4.2 ± 1.2	1.4 ± 1.2	5.6 ± 0.5	1.67 ± 0.5
≥24 (n = 25)	57 .0 ± 11.1	3.59 ± 5.4	6.0 ± 0.7	9.3 ± 0.7	5.4 ± 0.6	3.8 ± 1.5	6.4 ± 0.7	1.94 ± 0.25
p-value	<0.05	<0.05	0.44	<0.05	<0.05	<0.05	<0.05	0.08

^* Response was defined as the difference of Jankovic rating scores before and after 3 month botox treatment.

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