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Definition

What is blepharospasm?

To understand easily we should understand two parts of this word. Blepharo means “eyelid”. Spasm means “uncontrolled muscle contraction”. Blepharospasm is a repetitive, involuntary spasm of the eyelid muscles.

The upper lid is a place where usually occurs a twitch, but it can occur in both the upper and lower lids. These spasms commonly are very mild and feel like a gentle tug on the eyelid. Others may experience a spasm strong enough that it forces you to close your eyelid completely. Besides, some people never have any noticeable signs.

The twitches are painless and harmless, but they may bother and cause some troubles for you. Most spasms will resolve on their own without the need for treatment.

In rare cases, eyelid spasms may be an early warning sign of a chronic movement disorder, especially if the spasms are related to other facial twitches or uncontrollable movements.

How common is blepharospasm?

Blepharospasm is increasingly being recognized as cause of disability. It affects about 32/100,000 people. It typically starts in 5th or 6th decade of life and much more common in women (3:1). Please discuss with your doctor for further information.

Symptoms

What are the symptoms of blepharospasm?

The common symptoms of blepharospasm are:

  • Blink rate
  • Eyelid spasms
  • Eye irritation
  • Midfacial or lower facial spasm
  • Brow spasm
  • Eyelid tic
  • Tearing
  • Eye irritation
  • Photophobia
  • Vague ocular pain

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Your eye is red, swollen, or has an unusual discharge.
  • Your upper eyelid is drooping.
  • Your eyelid completely closes each time your eyelids twitch.
  • The twitching continues for several weeks.
  • The twitching begins affecting other parts of your face.

Causes

What causes blepharospasm?

Eyelid spasms may occur without any identifiable cause, and because they are rarely a sign of a serious problem, the cause is not usually investigated. Nevertheless, eyelid twitches may be caused or made worse by:

  • Dizziness
  • Eye irritation
  • Eyelid strain
  • Fatigue
  • Lack of sleep
  • Physical exertion
  • Medication side effects
  • Stress
  • Use of alcohol, tobacco, or caffeine

If the spasms become chronic, it is known as “benign essential blepharospasm,” which is the name for chronic and uncontrollable eyelid movement. This condition typically affects both eyes.

Risk factors

What increases my risk for blepharospasm?

There are many risk factors for blepharospasm, such as:

  • Head or facial trauma.
  • Family history of dystonia or tremor.
  • Reflex blepharospasm is reportedly triggered by severely dry eyes and blepharitis, intraocular inflammation, meningeal irritation, light sensitivity.
  • Stress may exacerbate benign essential blepharospasm.
  • Medications, such as those used to treat Parkinson’s disease, have been associated with blepharospasm.
  • Earlier studies suggested that cigarette smoking was a negative risk factor, but more recent studies no longer support this.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is blepharospasm diagnosed?

Clinical diagnosis.  The diagnosis of blepharospasm is clinical and is made by careful history taking and physical exam.

Diagnostic procedures. Benign essential blepharospasm is a clinical diagnosis and a diagnosis of exclusion. Neuroradiologic studies are generally unrevealing and rarely indicated in the workup.

Laboratory test. Laboratory tests have no utility in the diagnosis and workup of blepharospasm.

Differential diagnosis

  • Ocular myokymia
  • Secondary to ocular irritation (ie dry eyes, blepharitis,…
  • Facial tics (Tourette syndrome)
  • Hemifacial spasm (contraction of the entire one side of the face)
  • Cerebral palsy
  • Functional (Focal brain injury or tumor)
  • Focal seizures
  • Infection

 

How is blepharospasm treated?

Most eyelid spasms will disappear without treatment in a few days or weeks. To ease eye twitching, you should reduce stress and try the following:

  • Drink less caffeine.
  • Get adequate sleep.
  • Keep your eye surfaces and membranes lubricated with over-the-counter artificial tears or eye drops.
  • Apply a warm compress to your eyes when a spasm begins.

Surgery to remove some of the muscles and nerves in the eyelids (myectomy). It is used to treat more severe cases of benign essential blepharospasm. Physical therapy may also be useful for training the muscles in your face to relax.

Another treatments included:

  • acupuncture
  • biofeedback
  • hypnosis
  • massage therapy
  • nutrition therapy
  • psychotherapy, which can be helpful for Tourette’s syndrome
  • tai chi
  • yoga and other meditation techniques for relaxation

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage blepharospasm?

The following lifestyles and home remedies might help you cope with blepharospasm:

  • If your eyelid spasms appear more frequently over time, keep a journal and note when they occur. Note your intake of caffeine, tobacco, and alcohol, as well as your level of stress and how much sleep you’ve been getting in the periods leading up to and during the eyelid twitching.
  • Try to go to bed 30 minutes to an hour earlier to help ease the strain on your eyelids and to reduce your spasms if you aren’t getting enough sleep and more spasm appears.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

 

Sources

Review Date: August 9, 2017 | Last Modified: August 9, 2017

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