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Blepharospasm (Benign Essential Blepharospasm) Benign essential Blepharospasm (BEB) is a condition in which the muscles around the eyelids go into periodic blinking spasms that squeeze the lids shut. Each time a spasm occurs the lids may remain tightly closed for seconds to minutes. In the early stages, the blinking may appear to be merely a
nervous twitch or a “bad habit”. Because
of this, most patients have BEB for a long time before becoming aware of
it. BEB usually comes on after the age
of 50, is more common in women than men, and may be hereditary (though this is
not been proven). Estimates of the
number of affected individuals in the In medical terms, “essential” means of unknown cause, “blepharo” means eyelid, and “spasm” means an involuntary, forceful contraction of muscles. Symptoms Early symptoms are winking, blinking, or squeezing together of the eyelids of one or both eyes or difficulty in keeping the eyes open. You may be especially sensitive to bright light. As the condition progresses, the spasms become more frequent until they are almost constant: both eyelids will clamp shut and the eyebrows will pull down. There may be accompanying facial spasms as well. Not everyone will experience the same symptoms. As the spasms increase in frequency and duration, it becomes more difficult to drive, read, watch television or perform routine daily activities. Because the eyelids cannot be opened at will, many individuals with BEB eventually become functionally “blind”. What Causes BEB? BEB is a neurological disorder (dystonia) involving the 7th (facial) cranial nerve. The cause is unknown at this time, but the symptoms are believed to come from a chemical imbalance that occurs within the brain centers that control movement. It is not due to any disease of the eyes themselves and it is not part of any generalized neurological conditions such as Parkinson’s disease. An unrelated but similarly-appearing condition that keeps the eyelids shut occurs temporarily when there is severe eye irritation, such as from the lashes scratching the cornea or from recent eye trauma. But in these cases the lid spasm tends to be more constant rather than periodic. Treatment Although at this point there is no cure for BEB, there are some treatments that reduce the severity of symptoms. Medications are available, but they are helpful in only about 15% of cases. A far more effective treatment which can produce good results in almost all patients is the injection of Oculinum (botulinum toxin, also called botox) into the muscles of the eyelid. The injections; however, may need to be repeated every few months. For those who are not helped by either medication or Oculinum, there is a surgical procedure to actually remove some of the muscles and nerves to those muscles that squeeze the lids shut. Both the injections and the surgery are meant to paralyze the lid muscles but they can result in unpleasant side effects, such as paralysis of the facial muscle. This may lead to drooping of the corner of the mouth (and some drooling) or excessive tearing. Fortunately, the side effects are usually temporary. Other treatments being used occasionally include biofeedback, acupuncture, hypnosis, chiropractic and nutritional therapy. These are controversial and the benefits are unconfirmed. Meige Syndrome Some of those with BEB also have Meige Syndrome (named for the doctor who first identified it; also called Brueghel’s Syndrome). This problem is more extensive and involves movements and spasms of the lower face, mouth, tongue, throat and neck. Sometimes even the voice is affected. It also is a neurological disorder of unknown origin. Additional Help Ongoing research to find a cure and/or better treatment for BEB and its related disorders is sponsored by the Benign Blepharospasm Research Foundation. The Foundation also maintains support groups throughout the country that can help patients and their families cope better with the disorder and the limitations it imposes. By offering encouragement and allowing participants to share experiences, such groups can be of considerable help. For more information, you can contact the: Benign Essential Blepharospasm Research Foundation Or call:
(409) 832-0788 |
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