Blepharospasm is an abnormal, involuntary spasm (twitching) of the eyelids. The underlying etiology is associated with the basal ganglia, an area of the brain which affects involuntary muscle control. Blepharospasm often starts with a gradual increase in blinking and periocular spasm. Strength and intensity can increase and affect facial muscles. Spasming can become very severe and affect activities of daily living such as driving and reading. Patients are often light-sensitive and experience facial fatigue. Triggers often include sunlight, stress, wind, and noise. Some patients learn techniques to diminish the spasms, known as “geste antagonistique,” with tongue thrusting, humming, mouth opening, extending the neck, closing one eye, or rubbing the face. Sleep and rest can improve symptoms. The spams often decrease or stop during sleep.
There is no cure for blepharospasm to date, but there are several treatments that can help to decrease the symptoms and improve quality of life. Dr. Rosh will discuss an individualized plan to help decrease the spasms. Neurotoxin injections into the eyelid and face can be done to paralyze the spasming muscles. These are usually covered by insurance and need to be repeated every 3-4 months. Oral medications can be used but are often unpredictable and provide short-term relief. A surgical option of a myectomy which is a procedure that involves removing the eyelid muscle can also be discussed. Alternative treatments like biofeedback, acupuncture, hypnosis are options, but their benefits have not been proven.