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Blepharospasm

Benign essential blepharospasm (BEB) is a progressive neurological disorder characterized by involuntary muscle contractions and spasms of the eyelid muscles. BEB begins gradually with occasional eye blinking and irritation. Blepharospasm usually begins with a gradual onset often precipitated by eye irritation or emotional stresses. With progression of the disorder, episodes of blepharospasm tend to worsen in severity often resulting in embarrassment and even loss of vision temporarily due to lid closure. Other symptoms may include involuntary winking or squinting of one or both eyes increasing difficulty in keeping the eyes open, and light sensitivity. As the condition progresses, the spasms may intensify, forcing the eyelids to remain closed for long periods of time and thereby causing substantial visual disturbance or functional blindness. Botulinum toxin, which comes from the bacteria known as Clostridium botulinum acts by temporarily causing disruption of nerve impulses to muscles. About 90% of patients will have complete relief of their symptoms with the first injection. Some patients will experience a droopy eyelid (ptosis) blurred vision or double vision following the injection, which may last several months. Patients who fail to have clinical resolution of symptoms with botulinum toxin injection, or do not wish to have the injection for any reason, may be candidates for surgery.

Blepharospasm is a focal dystonia characterized by increased blinking and involuntary closing of the eyes. "Benign" indicates the condition is not life threatening, and "essential" is a medical term meaning "of unknown cause". The eyes are normal but this prolonged closure obstructs vision. Generally the spasms occur during the day, disappear in sleep, and reappear after waking. Blepharospasm is quite different from the mild spasms of the lid that sometimes occur with stress use of caffeine or insufficient sleep and do not affect vision. The most common form of blepharospasm is called "benign essential blepharospasm " meaning it is not life threatening and is not due to some other identifiable disorder. It is important to note that the blindness is caused solely by the uncontrollable closing of the eyelids and not by a dysfunction of the eyes. BEB occurs in both men and women, although it is especially common in middle-aged and elderly women.

Causes of Blepharospasm

The common Blepharospasm :

• Stress or fatigue
• Dry eyes (not enough normal moisture in your eyes).
• 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.
• Photophobia (intolerance to light),
• Damage to the cornea (dome that forms the front of the eyeball) or dystonia (abnormal muscle rigidity causing spasms).
• Blepharospasm often occurs out of the blue for no specific reason.
• Rarely it can run in families.

Symptoms of Blepharospasm

Some Symptoms of Blepharospasm :

• Winking, blinking, or squinting that you cannot control .
• Trouble keeping your eyes open.
• Sensitivity to bright light.
• Uncontrollable tics or twitches of the eye muscles and surrounding facial area
• Dryness of the eyes.
• Fatigue.
• Facial spasms may develop.

Treatment of Blepharospasm

• 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 injections.
• Stress management and support groups can help sufferers deal with the disease and prevent social isolation.
• Those patients that have not responded well to medication or botulinum toxin injection are candidates for surgical therapy. The most effective surgical treatment has been protractor myectomy, the removal of muscles responsible for eyelid closure.
• Dark glasses for sunlight sensitivity as well as to cover one's eyes from other people.
• Injection of medicines to paralyze muscles (like botox).

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