Blepharospasm

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Blepharospasm is a focal dystonia characterized by increased blinking and involuntary closing of the eyes. This form may be primary or secondary. People with blepharospasm have normal vision.

When vision is impaired, it is due solely to the forced closure of the eyelids. Blepharospasm may be referred to as a “cranial dystonia.” Cranial dystonia is a broad description of dystonia that affects any part of the head.

Terms used to describe blepharospasm include: eye dystonia, cranial dystonia, adult onset focal dystonia. When blepharospasm occurs with dystonia in the face, the term Meige’s Syndrome may be used.

Symptoms

Blepharospasm affects the eye muscles and usually begins gradually with excessive blinking and/or eye irritation. In the early stages it may only occur with specific precipitating stressors such as bright lights, fatigue, and emotional tension. It is almost always present in both eyes.

As the condition progresses, symptoms may occur frequently during the day. The spasms disappear in sleep, and some people find that after a good night's sleep, spasms do not appear for several hours after waking. In a few cases, spasms may intensify so that the eyelids remain forcefully closed for several hours at a time.

Blepharospasm can occur with dystonia affecting the mouth and/or jaw (oromandibular dystonia). When blepharospasm and oromandibular dystonia occur together, the condition may be referred to as Meige's Syndrome. In such cases, spasms of the eyelids are accompanied by jaw clenching or mouth opening, grimacing, and tongue protrusion.

Cause

Blepharospasm may develop spontaneously with no known precipitating factor or be inherited. Some people with blepharospasm have family members with dystonia affecting different body areas.

Blepharospasm may be secondary due to drug exposure or occur in association with disorders such as parkinsonian syndromes and Wilson's disease.

Diagnosis

Diagnosis of blepharospasm is based on information from the affected individual and the physical and neurological examination. At this time, there is no test to confirm diagnosis of blepharospasm, and, in most cases, assorted laboratory tests are normal.

Blepharospasm should not be confused with:

Ptosis- drooping of the eyelids caused by weakness or paralysis of a levator muscle of the upper eyelid.

Blepharitis- an inflammatory condition of the lids due to infection or allergies.

Hemifacial spasm- a non-dystonic condition involving various muscles on one side of the face, often including the eyelid, and caused by irritation of the facial nerve. The muscle contractions are more rapid and transient than those of blepharospasm, and the condition is always confined to one side.

Treatment

One of the most effective treatments for blepharospasm is regular botulinum toxin injections to the affected muscles. Medications—including clonazepam, lorazepam, and trihexyphenidyl—are helpful in some cases. If botulinum toxin injections and medications are not effective, myectomy surgery in which portions of muscle are removed may also alleviate symptoms. Botulinum toxin injections may or may not be required following myectomy surgery.

To see the information about the treatment, Myectomy Surgery of Blepharospasm, please click here

Further Medical Information

The Benign Essential Blepharospasm Canadian Research Foundation (BEBCRF) has amassed a large body of information on the symptoms and treatment of Benign Essential Blepharospasm from expert medical professionals. This in-depth information can be accessed through their website, by clicking here

To see the difference between facial tic and blepharospasm, click here

To view the latest research related to blepharospasm, please click here.

Other Resources:

Facebook Blepharospasm Support Group: click here.

Patient Interview: Patricia Goodwin, diagnosed with Blepharospasm in 2009, discusses the condition in an interview here

Medical Practitioners with Specialization in Dystonia/BEB/Hemifacial Spasm:

To get in touch with one of these medical practitioners, click on the doctor’s name to access their contact information.

Harmeet S. Gill MD, FACS FRCSC

David R. Jordan MD. FACS, FRCSC

Stephen P. Kraft MD. FRCSC

Earl Consky   MD

Yasser Khan MD, FRSCS

Anthony M. Kaufmann, MD, BSc (Med) MSc FRCSC

Find an opthalmologist here.

Find an oculoplastic surgeon here

Please note that patients require a referral from their family physician to see an ophthalmologist or oculoplastic surgeon.

Coming Soon:

Blepharospasm contact: Email/Phone (TBD)

Dyfying Dystonia podcast  

Youtube Channel Playlist


Brochures:
Blepharospasm Dystonia Brochure
BEBCRF Brochure