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Essential blepharospasm: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Essential blepharospasm is an idiopathic progressing disease, accompanied by involuntary tonic spastic contractions of the circular muscles of the eyelids of both eyes lasting from a few seconds to several minutes and with years leading to the complete closure of the eyelids.
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What causes the essential blepharospasm?
The cause of the development of the essential blepharospasm is unknown, the central genesis of the lesion is assumed. The disease usually occurs in people older than 50 years, often associated with Parkinson's disease. Women get sick 3 times more often.
Symptoms of essential blepharospasm
Spasms are almost always bilateral, usually begin with slight twitchings, with the passage of time they can move into contractures and spasms of the muscles of the upper part of the face. In severe cases, the disease can progress until the patient becomes virtually blind. The provoking factors are stresses, bright light, visual load.
Differential diagnostics is performed with hemifacial spasm, MRI or MRI angiography is required to clarify the diagnosis. Neuralgia of the trigeminal nerve, extrapyramidal diseases (encephalitis, multiple sclerosis), psychogenic states can also be accompanied by blepharospasm. Differentiate from reflex blepharospasm, which occurs when stimulating branches of the trigeminal nerve (corneal ulcer, foreign body in the cornea, iridocyclitis).
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Treatment of essential blepharospasm
Treatment of essential blepharospasm can be conservative and surgical. Medicamentous methods of treatment of essential blepharospasm, as a rule, are ineffective. The method of choice is local injections of botulinum toxin (type A), which causes temporary paralysis of the circular eye muscle. Surgical treatment (myoectomy) is carried out with intolerance of botulinum toxin or ineffective treatment with this drug.
Essential blepharospasm as a whole is difficult to treat, the relapse after the injection of botulinum toxin occurs after 3-4 months, which requires repeated injections.