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Blepharospasm

A blepharospasm refers to any abnormal contraction or twitch of the eyelid.

Blepharospasm or eyelid twitching is an involuntary spasm of the eyelid muscle.

The most common factors that make the muscle in the eyelid twitch are fatigue, stress, and caffeine.

Eyelid twitching is not considered a harmful condition and therefore there is no treatment available.

Patients are however advised to get more sleep and drink less caffeine.

There are two types of blepharospasm: essential and reflex blepharospasm.

Benign essential blepharospasm is a focal dystonia involving involuntary and sustained contractions of the muscles around the eyes.

In essential bletharospasm the cause is unknown, but fatigue, stress, or an irritant are possible contributing factors.

Symptoms last for a few days then disappear without treatment in most cases.

The twitching may become chronic and persistent, causing significant distress.

Rarely symptoms are severe enough to result in functional blindness.

Patients experience eyelids that are clamping shut and will not open without great effort.

Patients have normal eyes, but are effectively blind due to their inability to open their eyelids.

In reflex blepharospasm there is pain in and around the eye.

Often mis-diagnosed as allergies or dry eye syndrome.

Affects only one in every 20,000 people in the United States.

Characterized by uncontrollable eyelid closure of durations longer than the typical blink reflex, and can sometimes last minutes or even hours.

Uncontrollable contractions or twitches of the eye muscles and surrounding facial area, may radiate into the nose, face and sometimes, the neck area manifesting by twitches.

May result in dryness of the eyes, with sensitivity to the sun and bright light.

Some drugs can induce blepharospasm, including anti-Parkinson’s disease agents.

May be associated with hormonal replacement therapy.

Can be related to acute withdrawal from benzodiazepines or to their prolonged use.

May be associated with basal ganglia dysfunction from head trauma, and may occur in multiple sclerosis.

Drug therapy is unpredictable.

Botulinum toxin injections can be used to induce localized, partial paralysis of the eyelids, and is the pref2242ed treatment method.

Botulinum injections are generally administered every three months, and usually provide immediate relief and normal activities.

A minority of patients do not respond botulinum injections.

Botulinum toxin effectiveness may diminish after many years of use.

Occasional side effect of botulinum toxin is ptosis.

For patients that do not respond to medication or botulinum toxin injection are candidates for surgical therapy.

The most effective surgical treatment is a protractor myectomy, the removal of muscles responsible for eyelid closure.

Dark glasses are often worn for sunlight sensitivity, as well as to hide the eyes from others.

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