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BLEPHAROSPASM

Blepharospasm is a condition characterized by involuntary and forceful complete or partial closing of one or both eyelids due to contractions of the orbicularis oculi muscle.

CAUSES

The cause of primary blepharospasm is unknown though it is associated with abnormal function of a part of the brain known as the basal ganglia. Secondary blepharospasm can be caused by eye conditions like blepharitis, dry eyes, eye trauma, glaucoma, trichiasis and uveitis.

Other causes of secondary blepharospasm that are not related to the eye include atypical Parkinson’s disease, brain injury, cerebral palsy, multiple sclerosis, Tourette’s syndrome and tardive dyskinesia. Medications like olanzapine can also cause eyelid spasms.

SYMPTOMS

Symptoms of blepharospasm include abnormal blinking which is faster than the normal 10 to 20 times a minute. These eye spasms usually occur in bright light and they can either increase or decrease when a person is reading or watching television. Eyelid twitching, tics and eye irritation are other symptoms associated with blepharospasm.

TREATMENT

There is no cure for blepharospasm. Treatment includes general measures like managing any underlying diseases. This can include using artificial tears to manage dry eyes as it often improves the symptoms. Dark sunglasses with ultraviolet blocking should also be worn since studies have shown that they reduce the rate of blinking and the sensitivity to light that can cause pain and trigger the condition.

Maneuvers like pulling the eyelid, pinching the neck, talking, yawning, humming and singing can also be used as they help some patients.

Medications used to treat blepharospasms include tetrabenazine which has been found to be beneficial for some patients.

Botulinum toxin type A, which is commonly known as Botox, is also used to treat blepharospam. This medication which is produced by the bacteria Clostridia botulinum, is injected into the eyelid muscle orbicularis oculi to paralyze it. It was found in a study to be highly effective in 90% of patients who used it compared to a placebo. Repeat injections are required since the effects usually last for a few months.  Potential side effects of botox include dry eyes,  ptosis and diplopia (double vision).  This, however, by far considered the most effective treatment.

Surgery is also used to treat blepharospasm that affects the vision and that does not respond to medications or botox. This usually involves protractor myomectomy which is removal of some of the muscles that close the eye.

Treatment of blepharospasm is important because without treatment the condition can progressively worsen as the symptoms become more frequent. Facial spasms can also develop. Blepharospasm can also have profound effects on a person’s quality of life by affecting their vision and activities like reading and driving. The eye spasms can even render them functionally blind even when their visual acuity is normal. In addition, the persistent blinking can also cause social embarrassment.

RESEARCH

The latest research on blepharospasm reveals that deep brain stimulation (DBS) can be used to treat primary or essential blepharospasm. In this procedure electrodes are implanted in the brain and connected to a battery operated pulse generator which is implanted just under the skin in the chest. This pulse generator sends impulses to the brain to control the abnormal eye muscle movements.  DBS for blepharospasm has not yet been approved by the FDA.

SUPPORT

The area representative for persons with blepharospasm in Tennessee is Sonya Miller who can be reached by telephone at 615 367 0969 or via email at cmsa57@bellsouth.net. Her address is 224 Clearlake Dr. W Nashville, TN, 37217-4502

Support group meetings are also held for persons with blepharospams in Tennessee. The next meeting will be held on Saturday, September 13, 2014 from 1 to 3 pm at Una Church of Christ on 1917 Old Murfreesboro Rd, Nashville, TN, 37217. The speaker will be Dr. Lucy Ledbetter who is a neurologist and the contact person is Sonya Miller.

 

 

 

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Posted on

September 4, 2014