Vidyya Medical News Service
Volume 6 Issue 140 Published - 14:00 UTC 08:00 EST 19-May-2004 Next Update - 14:00 UTC 08:00 EST 20-May-2004
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Information for patients: Blepharospasm

Other Names

Benign essential blepharospasm, hemifacial spasm.

What is Blepharospasm?

Blepharospasm is an abnormal, involuntary blinking or spasm of the eyelids.

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What causes Blepharospasm?

Blepharospasm is associated with an abnormal function of the basal ganglion from an unknown cause. The basal ganglion is the part of the brain responsible for controlling the muscles. In rare cases, heredity may play a role in the development of blepharospasm.

What are the symptoms of Blepharospasm?

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. As the condition progresses, the symptoms become more frequent, and facial spasms may develop. Blepharospasm may decrease or cease while a person is sleeping or concentrating on a specific task.

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How is Blepharospasm treated?

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

In the United States and Canada, the injection of Oculinum (botulinum toxin, or Botox¨) 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. 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. The benefits of these alternative therapies have not been proven.

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Mexiletine for the Treatment of Focal Dystonia
The National Institute of Neurological Disorders and Stroke (NINDS) is currently recruiting patients to test the effectiveness of mexilitine, an oral medication, to treat Dystonia (involuntary muscle contractions). Patients will be evaluated by clinical rating scales and neurophysiological studies. In addition, researchers will test patient's reflexes in an attempt to find out where mexilitine works in the nervous system. For further information on this study, please visit the NINDS' website at or contact the NIH Patient Recruitment and Public Liaison Office at 1-800-411-1222.

The Doxil® Blepharospasm Treatment Trial
Doxorubicin injections in the eyelids are being studied as a way of relieving muscle spasms. Patients who participated in this study have experienced symptom relief since their last injection. No definite conclusions have been reached at this time. For additional information about this clinical trial, please visit the University of Minnesota Department of Ophthalmology website at or contact:

Jonathan D. Wirtschafter, M.D.
Department of Ophthalmology
University of Minnesota - FUMC Box 493
420 Delaware Street SE
Minneapolis, MN 55455-0501
(612) 625-4400

Other Resources

The following resources may provide additional information on blepharospasm:

National Institute of Neurological Disorders and Stroke (NINDS)
National Institutes of Health
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
Distributes an information page on benign essential blepharospasm.

Benign Essential Blepharospasm Research Foundation, Inc.
P.O. Box 12468
Beaumont, TX 77726-2468
(409) 832-0788
Promotes research into the cause, treatment, and potential cure of benign essential blepharospasm and other disorders of the facial musculature. Acts as a clearinghouse for information on these disorders and distributes materials, including printed brochures, bimonthly newsletters, and factsheets.

Office of Medical Applications of Research
National Institutes of Health
Building 31, Room 1B03
31 Center Drive, MSC 2082
Bethesda, MD 20892-2082
Distributes Clinical Use of Botulinum Toxin Consensus Development Conference Statement, November 12-14, 1990.

For additional information, you may also wish to contact a local library.

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Medical Literature

Below is a sample of the citations available in MEDLINE, a comprehensive medical literature database coordinated by the National Library of Medicine (NLM). MEDLINE contains information on medical journal articles published from 1966 to the present. You can conduct your own free literature search by accessing MEDLINE through the Internet at You can also get assistance with a literature search at a local library.

To obtain copies of any of the articles listed below, contact a local community, university, or medical library. If the library you visit does not have a copy of a particular article, you may usually obtain it through an inter-library loan.

Please keep in mind that articles in the medical literature are usually written in technical language. We encourage you to share any articles you order with a health care professional who can help you understand them.

Blepharospasm: Report of a Workshop. Hallett M, Darof, R. Bethesda, Maryland. Neurology; 46(5):1213-1218, May 1996.
This article discusses the anatomy and physiology of the eyelid, clinical aspects of blepharospasm, and treatment options.

Pharmacotherapy with Botulinum Toxin: Harnessing Nature's Most Potent Neurotoxin. Bell MS, Vermeulen LC, Sperling KB. Pharmacotherapy 20(9):1079-91, September 2000.
This article begins with a brief overview of the use of botulinum toxin. Following is a discussion of the past uses of the botulinum toxin and the advances that have been made in its use as a pharmacological treatment for neurological disorders. The article also provides information on the safety and the efficacy of botulinum toxin.

The National Eye Institute (NEI), part of the National Institutes of Health (NIH), is the Federal government's principal agency for conducting and supporting vision research. Inclusion of an item in this Information Resource Guide does not imply the endorsement by the NEI or the NIH.

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