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Last update January 30, 2009
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 Contents of the Blepharospasm Pages

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FAQ about Blepharospasm and Meige

Blepharospasm

Meige's Syndrome

Hemifacial Spasm

Apraxia of Eyelid Opening

Current Forms of Therapy?

Scientific Presentations from the BEBRF Annual Conferences

Support

Other Resources

Blepharospasm Research

Raise Money for BEBRF

Questions or Comments

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What is Blepharospasm?

Blepharo means "eyelid". Spasm means "uncontrolled muscle contraction". The term blepharospasm ['blef-a-ro-spaz-m] can be applied to any abnormal blinking or eyelid tic or twitch resulting from any cause, ranging from dry eyes to Tourette's syndrome to tardive dyskinesia. The blepharospasm referred to here is officially called benign essential blepharospasm (BEB) to distinguish it from the less serious secondary blinking disorders. "Benign" indicates the condition is not life threatening, and "essential" is a medical term meaning "of unknown cause". It is both a cranial and a focal dystonia. Cranial refers to the head and focal indicates confinement to one part. The word dystonia describes abnormal involuntary sustained muscle contractions and spasms. Patients with blepharospasm have normal eyes. The visual disturbance is due solely to the forced closure of the eyelids.

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

The first part of Dr. Miller's video, "Diagnosis & Treatment with Botox of Patients with Benign Essential Blepharospasm & Related Disorders", shows different ways in which blepharospasm may manifest itself.

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How Does Blepharospasm Begin?

Blepharospasm 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. As the condition progresses, it occurs frequently during the day. The spasms disappear in sleep, and some people find that after a good night's sleep, the spasms don't appear for several hours after waking. Concentrating on a specific task may reduce the frequency of the spasms. As the condition progresses, the spasms may intensify so that when they occur, the patient is functionally blind; and the eyelids may remain forcefully closed for several hours at a time.

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What Causes Blepharospasm?

Blepharospasm is thought to be due to abnormal functioning of the basal ganglia which are situated at the base of the brain. The basal ganglia play a role in all coordinated movements. We still do not know what goes wrong in the basal ganglia. It may be there is a disturbance of various "messenger" chemicals involved in transmitting information from one nerve cell to another. In most people blepharospasm develops spontaneously with no known precipitating factor. However, it has been observed that the signs and symptoms of dry eye frequently precede and/or occur concomitantly with blepharospasm. It has been suggested that dry eye may trigger the onset of blepharospasm in susceptible persons. Infrequently, it may be a familial disease with more than one family member affected. Blepharospasm can occur with dystonia affecting the mouth and/or jaw (oromandibular dystonia, Meige syndrome). In such cases, spasms of the eyelids are accompanied by jaw clenching or mouth opening, grimacing, and tongue protrusion. Blepharospasm can be induced by drugs, such as those used to treat Parkinson's disease. When it is due to antiparkinsonian drugs, reducing the dose alleviates the problem.

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Disclaimer

The BEBRF blepharospasm pages are intended to provide information - not to advocate particular treatment options. Thus, it is strongly urged that patients do not change treatment without first consulting their physician.

Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, webmaster and the BEBRF are not responsible for errors or omissions or for any consequences from application of the information on this website and make no warranty, expressed or implied, with respect to the contents of the publication.

The authors, editors, and the BEBRF have exerted every effort to ensure that drug selection and dosage set forth in this site are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.

Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.

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Questions or Comments about the BEBRF Blepharospasm Pages

If these pages are to be as useful and relevant to you as possible, we need your feedback. Comments or suggestions about the page itself (layout, new links, bad links, additional topics) should be addressed to BEBRF Webmaster. Medical questions or questions about where to obtain additional resources should be directed to the Blepharospasm Research Foundation.

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