Blepharospasm

Blepharospasm

Left orbicularis oculi, seen from behind.
Classification and external resources
Pronunciation blĕf′ə-rō-spăz′əm
Specialty neurology
ICD-10 G24.5
ICD-9-CM 333.81
OMIM 606798
DiseasesDB 15748
MedlinePlus 000756
eMedicine oph/202
Patient UK Blepharospasm
MeSH D001764

Blepharospasm is any abnormal contraction or twitch of the eyelid. In most cases, symptoms last for a few days then disappear without treatment, but sometimes the twitching is chronic and persistent, causing lifelong challenges. In those rare cases, the symptoms are often severe enough to result in functional blindness. The person's eyelids feel like they are clamping shut and will not open without great effort. People have normal eyes, but for periods of time are effectively blind due to their inability to open their eyelids. In contrast, the reflex blepharospasm is due to any pain in and around the eye.

It is of two types: essential and reflex blepharospasm. The benign essential blepharospasm is a focal dystonia—a neurological movement disorder involving involuntary and sustained contractions of the muscles around the eyes. The term essential indicates that the cause is unknown, but fatigue, stress, or an irritant are possible contributing factors.

Although there is no cure botulinum toxin injections may help temporarily.[1][2] A surgical procedure known as myectomy may also be useful.[1] It is a fairly rare disease, affecting only one in every 20,000 people in the United States. The word is from Greek: βλέφαρον / blepharon, eyelid, and σπασμός / spasmos, spasm, an uncontrolled muscle contraction.

Symptoms

Causes

Some causes of blepharospasm have been identified; however, the causes of many cases of blepharospasm remain unknown, although some educated guesses are being made. Some blepharospasm patients have a history of dry eyes and/or light sensitivity, but others report no previous eye problems before onset of initial symptoms.

Some drugs can induce blepharospasm, such as those used to treat Parkinson's disease, as well as sensitivity to hormone treatments, including estrogen-replacement therapy for women going through menopause. Blepharospasm can also be a symptom of acute withdrawal from benzodiazepines. In addition to blepharospasm being a benzodiazepine withdrawal symptom, prolonged use of benzodiazepines can induce blepharospasm and is a known risk factor for the development of blepharospasm.[4]

Blepharospasm may also come from abnormal functioning of the brain basal ganglia. Simultaneous dry eye and dystonias such as Meige's syndrome have been observed. Blepharospasms can be caused by concussions in some rare cases, when a blow to the back of the head damages the basal ganglia.

Multiple sclerosis can cause blepharospasm.[5]

Treatment

See also

References

  1. 1 2 "Facts About Blepharospasm". August 2009. Retrieved 19 March 2015.
  2. Simpson, D. M.; Hallett, M.; Ashman, E. J.; Comella, C. L.; Green, M. W.; Gronseth, G. S.; Armstrong, M. J.; Gloss, D.; Potrebic, S.; Jankovic, J.; Karp, B. P.; Naumann, M.; So, Y. T.; Yablon, S. A. (18 April 2016). "Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology". Neurology. doi:10.1212/WNL.0000000000002560.
  3. Adams WH, Digre KB, Patel BC, Anderson RL, Warner JE, Katz BJ (July 2006). "The evaluation of light sensitivity in benign essential blepharospasm". American Journal of Ophthalmology 142 (1): 82–87. doi:10.1016/j.ajo.2006.02.020. PMID 16815254.
  4. Wakakura M, Tsubouchi T, Inouye J (March 2004). "Etizolam and benzodiazepine induced blepharospasm". Journal of Neurology, Neurosurgery, and Psychiatry 75 (3): 506–7. doi:10.1136/jnnp.2003.019869. PMC: 1738986. PMID 14966178.
  5. Goldman, Lee. Goldman's Cecil Medicine (24th ed.). Philadelphia: Elsevier Saunders. p. 2429. ISBN 1437727883.
  6. Piyasena INAP, Jayasinghe JAC (March 2014). "Mosapride (5HT4 agonist) in the treatment of blepharospasm.". Ceylon Med J. 59 (1): 26–7. doi:10.4038/cmj.v59i1.5527. PMID 24682196.
  7. Schellini SA, Matai O, Igami TZ, Padovani CR, Padovani CP (2006). "Blefarospasmo essencial e espasmo hemifacial: características dos pacientes, tratamento com toxina botulínica A e revisão da literatura" [Essential blepharospasm and hemifacial spasm: characteristic of the patient, botulinum toxin A treatment and literature review]. Arquivos Brasileiros De Oftalmologia (in Portuguese) 69 (1): 23–6. doi:10.1590/S0004-27492006000100005. PMID 16491229.
  8. Anderson RL, Patel BC, Holds JB, Jordan DR (September 1998). "Blepharospasm: past, present, and future". Ophthalmic Plastic and Reconstructive Surgery 14 (5): 305–17. doi:10.1097/00002341-199809000-00002. PMID 9783280.

External links

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