Blepharospasm

Our eyelids help protect our eyes. (Read about "The Eye") Blepharospasm is an abnormal, involuntary blinking or spasm of the eyelids, according to the National Eye Institute (NEI). Blepharospasm is associated with an abnormal function of the basal ganglia from an unknown cause. Deep in the brain, the basal ganglia are clusters of nerve cells surrounding the thalamus. (Read about "The Brain") They are responsible for initiating and integrating movements. In rare cases, heredity may play a role in the development of blepharospasm, says NEI.

The National Institute of Neurological Disorders and Stroke (NINDS) calls it benign essential blepharospasm (BEB). NINDS says it is a progressive neurological disorder characterized by involuntary muscle contractions and spasms of the eyelid muscles. It is a form of dystonia, a movement disorder in which muscle contractions cause sustained eyelid closure, twitching or repetitive movements. (Read about "Dystonia") BEB begins gradually with occasional eye blinking and/or irritation.

Symptoms

NEI says most people develop blepharospasm without any warning symptoms. It may begin with a gradual increase in blinking or eye irritation. Some people may also experience fatigue, emotional tension or sensitivity to bright light. Other symptoms, according to NINDS, may include involuntary winking or squinting of one or both eyes, increasing difficulty in keeping the eyes open and light sensitivity. Generally, the spasms occur during the day, disappear in sleep, and reappear after waking. As the condition progresses, the spasms may intensify, forcing the eyelids to remain closed for long periods of time, and thereby causing substantial visual disturbance or functional blindness. NINDS says it is important to note that the blindness is caused solely by the uncontrollable closing of the eyelids and not by a dysfunction of the eyes. BEB occurs in both men and women, although it is especially common in middle-aged and elderly women.

As the condition progresses, the symptoms become more frequent and facial spasms may develop.

Treatment

To date, there is no successful cure for blepharospasm, according to NEI, although several treatment options can reduce its severity.

NINDS says the injection of botulinum toxin into the muscles of the eyelids is an approved treatment for blepharospasm. Botulinum toxin, produced by the bacterium Clostridium botulinum, paralyzes the muscles of the eyelids.

Medications taken by mouth for blepharospasm are available but usually produce unpredictable results, according to NEI. Any symptom relief is usually short-term and tends to be helpful in only 15 percent of the cases.

Myectomy, a surgical procedure to remove some of the muscles and nerves of the eyelids, is also a possible treatment option. This surgery has improved symptoms in 75 to 85 percent of people with blepharospasm.

Alternative treatments may include biofeedback, acupuncture, hypnosis, chiropractic and nutritional therapy. (Read about biofeedback, acupuncture, hypnosis & chiropractic care in "CAM Therapies") The benefits of these alternative therapies have not been proven, according to NEI.