Blepharospasm |
| What is Blepharospasm? |
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| Blepharospasm is a common term for conditions that are medically known as Benign Essential Blepharospasm and Essential Blepharospasm. A blepharospasm is defined as "a chronic, unremitting,
bilateral, variably progressive dysfunction of the nerve that controls the muscles around the eye." It manifests itself as an uncontrollable, forcible closure of the eyelids. It often affects both eyes at once, but it can also
affect only one eye. In some cases, other muscles in the face can twitch as well, especially around the cheek and brow. Severe blepharospasm can cause the eyelids to be forcibly closed for a duration longer than the typical blink reflex, causing a variable interruption in the ability to see. |
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| Benign Essential Blepharospasm and Essential Blepharospasm are caused by abnormal nerve impulses to the eyelid muscles. Years ago, many patients were told that Essential Blepharospasm was caused by psychiatric problems. Now, it is known that this was not true. |
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| Are There Different Forms of Blepharospasm? |
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| Yes, blepharospasms are classified by their severity and the extent of the face that is affected. The basic classifications of blepharospasms are as follows: |
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Benign Essential Blepharospasms (also called Essential Blepharospasm)
Hemifacial spasms or Meige's Syndrome
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| What are the Symptoms of Blepharospasm? |
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| The early symptoms of blepharospasm include occasional, involuntary winking, blinking, or squinting of one or both eyes. It may also manifest itself as an increased difficulty in keeping the eyes open. Light sensitivity is a common occurrence with blepharospasm patients. |
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| As the condition progresses, the eyelid spasms increase in frequency and severity until they are unremitting, leaving both eyelids clamped shut and the eyebrows pulled down. In some cases, only one eye is affected. |
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| Risk Factors for Blepharospasm |
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| The cause of blepharospasm is unknown. Studies indicate an area of the brain called the "basal ganglia" may be involved. Symptoms occur most frequently in persons in their 50s and 60s. Women are three times more likely to have the condition than men. |
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| What is the Treatment for Blepharospasm? |
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| There are three accepted treatments for blepharospasm. They are (1) the neurological approach, (2) the surgical approach, and (3) the use of the Botulinum toxin (Botox) injections. |
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| Neurological Approach: |
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| In mild cases, doctors may prescribe medications or recommend biofeedback training. The medical approach to treatment has been limited primarily to drug therapy. Moderate success has been reported in controlling blepharospasm through the use of diazepam, levodopa, methyldopa, lithium, clonopine, lioresal, and tetrabenzine. Unfortunately, these treatments are not always successful. |
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| Surgical Approach: |
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| Two surgical approaches, and their variations, have limited results with the need for frequent repeat procedures. The myectomy procedure involves resection and removal of muscles in the upper eyelids and
brow. A neurectomy procedure involves resection and removal of the small facial branches of the orbicularis muscles. This procedure is rarely performed. |
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| Botulinum Toxin (Botox) Injections: |
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| Physicians have reported good results with Botulinum Toxin (Botox) injections. The toxin is produced by the same bacteria responsible for a type of food poisoning called botulism when consumed in large amounts. However, when very small amounts of the Botulinum toxin are injected into the eyelid muscles, it is quite safe and very effective in stopping eyelid spasm for up to several months. |
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| The effectiveness of the Botox injection is temporary; therefore, periodic injections are required for control of blepharospasms. Botox injections are now the treatment of choice for blepharospasm. |
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| As with almost any medical procedure, there can be side effects of Botulinum toxin injections. Some people may develop a drooping eyelid, double vision, or dryness of the eye. Fortunately, these side effects wear off with time. |
