Benign Essential Blepharospasm

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Benign Essential Blepharospasm

The term blepharospasm, from 'blepharo' (eyelid) and 'spasm' (uncontrolled muscle contraction), is the bilateral, involuntary contractions or tic of the facial muscles. It is important to distinguish benign essential blepharospasm from hemifacial spasm. Hemifacial spasm occurs on one side of the face and may result from compression of the facial nerve, which needs proper medical evaluation.

Benign essential blepharospasm is normally distinguished from less serious disorders and is a focal dystonia (a neurological movement disorder involving involuntary and sustained muscle contractions) of the muscles around the eyes.

Symptoms

• Uncontrollable tics or twitches of the eye muscles and surrounding facial area.
• Excessive blinking of the eyes, or forced closure of durations longer than the typlical blink reflex.
• Dryness of the eyes.
• Sensitivity to the sun and bright light (photosensitivity).
• Usually bilateral and symmetric.

Causes
In most cases, blepharospasm seems to develop spontaneously. Its causes are generally unknown, but likely from abnormal functioning of the brain's basal ganglia. Concomitance with dry eye, as well as other dystonias such as Meige's syndrome has been observed. Some drugs can induce blepharospasm.

Treatment

• Drug therapy: Drug therapy for blepharospasm has proved generally unpredictable and short-lasted. Finding an effective regimen for any patient usually requires patience of patient and physician.
• Botulin toxin - Type A (Botox®) injections.
• Dark glasses, for sunlight sensitivity as well as to cover one's eyes from other people.
• Stress management and support groups can help sufferers deal with the disease and prevent social isolation.

REFERENCES
Ben Simon GJ, McCann JD. Benign essential blepharospasm. Int Ophthalmol Clin. 2005 Summer;45(3):49-75.

Hall TA, McGwin G Jr, Searcey K, Xie A, Hupp SL, Owsley C, Kline LB. Benign essential blepharospasm: risk factors with reference to hemifacial spasm. J Neuroophthalmol. 2005 Dec;25(4):280-5.