Blepharospasm is uncommon in the twitching, fluttering, or spasmodic closing of the eyelids. This is caused by the orbicularis oculi muscle spasm, the muscle that usually causes you to blink. Often people blink 10 to 20 times a minute, a little less when concentrating on reading or a computer screen. Increased frequency and power of blink is called blepharospasm Blepharospasm is primarily referred to here as benign essential blepharospasm (BEB).
The causes of blepharospasm are unclear, but changes in the way the brain operates are believed to be involved. One theory suggests that chemical signals do not travel from one nerve cell to another in the brain’s movement control centers (basal ganglia located at the base of the brain). No one knows what causes disfunction or harm. More than one family member is rarely affected by blepharospasm, which indicates that a genetic factor may be involved. In certain cases, dry eye symptoms either precede blepharospasm or start at the same time, but the meaning of this is not understood.
Blepharospasm treatments can include:
Stress management – During times of acute stress, symptoms appear to escalate. Understanding stress reduction strategies and joining the support group can be helpful.
Botox-Botulinum type A toxin is produced by the bacteria Clostridium botulinum. The drug, when administered, disrupts nerve signals to the muscles and induces paralysis. In general, repeated injections are given both above and below the eye. It takes between one and four days to start the paralysis. The full impact usually takes about a week. Botulinum toxin injections function for around 90 % of people with blepharospasm. Common but temporary side effects include dry eyes, drooping eyelid (ptosis), and double vision. Short-term blurred vision is normal
Medications – Medications such as lithium and diazepam are often used, but success rates differ. There is no appropriate treatment regimen, since one person, but not another, may be cured by a particular medication.
Surgery-Myectomy is a procedure requiring the removal of any (or all) of the eyelid and eyebrow muscles responsible for squinting. Typically, this treatment is performed after botulinum therapy has failed. Repeat operations can be needed in some cases. Myectomy reduces the effects of blepharospasm in up to 80 % of people who have blepharospasm. Blepharospasm does not generally get better without medication, but this has rarely happened.
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