Blepharospasm

Eyelid Spasms

Are there different types of eyelid spasms?

Yes. The three most common types of eyelid spasms are eyelid twitch (or tic), essential blepharospasm, and hemifacial spasm.

What causes minor eyelid spasms?

The cause of minor eyelid twitching is unknown. A slight spasm of the lower eyelid or even both eyelids is common and of no concern. Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, or correction of any refractive error may help.

What is essential blepharospasm?

Essential blepharospasm is an involuntary condition usually involving both eyes, where the eyelids and, sometimes, the eyebrows close involuntarily. In advanced cases, muscles of the mouth or neck are sometimes involved in these spasms. When these spasms occur, temporary inability to see may result because of the involuntary eyelid closure. These spasms are rare but very troublesome, and often incapacitating.

What causes blepharospasm?

Blepharospasm is caused by abnormal nerve impulses, which produce muscle spasm. It is almost never a psychiatric disease.

How can blepharospasm be treated?

Blepharospasm can be treated with medications, biofeedback, injection of botulinum and surgery.  Dr. Malitz has been treating blepharospastic conditions and migraines for years and is an expert with the use of botulinum toxin (Botox (R))

Medications and biofeedback are rarely successful in managing blepharospasm, but may be advised in mild cases or cases not responding to other treatment.

Botulinum injections are now the most commonly recommended treatment for blepharospasm. Injection of botulinum (botulism toxin) in very small quantities into the muscles around the eyes relaxes the spasm. The injection works for several months, but will slowly wear off and usually needs to be repeated.

The treatment is very successful with few side effects. Drooping of the eyelids, double vision or dryness of the eye are possible side effects, but occur rarely and will subside as the injection wears off.

Surgery may also be recommended by Dr Malitz. The surgeon removes either the nerve causing the spasm or the spastic muscles themselves. The surgical results are generally permanent and any side effects are also usually permanent.

What is hemifacial spasm?

Hemifacial spasm is a condition which involves the eyelid muscles and usually the muscles around the mouth on only one side of the face. Hemifacial spasm is usually caused by an artery pressing on the nerve to the facial muscles, causing the face to twitch. Botulinum injections may be beneficial in relieving the eyelid spasms in patients with hemifacial spasm.

A neurosurgical procedure for hemifacial spasm may relieve the pressure of the artery on the nerve. While it is generally successful, it is a major neurosurgical operation and serious complications are possible.  The best treatment is botulinum toxin injections on a periodic basis.  We find that these injections when appropriately administered can last over 6 months.