Blepharospasm: causes, symptoms, diagnosis, treatment

Blepharospasm is a spasm of the muscles around the eye, causing an involuntary blinking and closing of the eye.

What causes blepharospasm?

Blepharospasm arises reflexively in diseases of the cornea. It is especially pronounced in children with tuberculosis-allergic keratoconjunctivitis. Eyelids convulsively compressed, the patient is unable to open them because of photophobia. With prolonged spasm there is a stagnant swelling of the eyelids.

Blepharospasm can occur as a result of other eye diseases, but most often the cause is unknown. Women develop more often than men, and have a family history. Secondary blepharospasm can also occur in people with eye irritation (eg, with trichiasis, foreign corneal body, dry keratoconjunctivitis) and in systemic neurological diseases (eg Parkinson's disease).

How does blepharospasm manifest itself?

Symptoms include involuntary blinking and closing of the eyes; in severe cases, patients can not open their eyes. Spasms can worsen with fatigue, light and anxiety.

Blepharospasm is a progressive disease accompanied by involuntary tonic spastic contractions of the circular muscles of both eyes lasting from several seconds to several minutes - a clonic (rapid and intense blinking); tonic contraction (spasm), leading to a narrowing of the eye gap and over the years even to complete closure. The disease usually occurs in people older than 50 years, often associated with Parkinson's disease. Women get sick three times more often. There may be a one- and two-sided spasm, combined with a spasm of the muscles of the face, arms, legs. The cause of the development of the disease is assumed to be the central genesis of the lesion of the nervous system. There may be painful tics in the case of neuralgia (irritations) of the trigeminal nerve with dental caries, nasal polyps, after a neuroinfection and mental trauma, may be caused by diseases of the anterior part of the eye, with electro-ophthalmia, etc. It is often observed in conjunctival and corneal lesions, often in children 7 -8 years after the infection, mental trauma, if you get foreign eyelids and for a number of eye diseases "when the spasm of the eyelid develops reflexively.

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 disease (encephalitis, multiple sclerosis), psychogenic states can 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).

Treatment of blepharospasm

Treatment of blepharospasm can be conservative and surgical. Treatment depends on the cause of the disease. In some cases, periorbital novocain blockades, massage, bromine preparations, analgesics, 1% solution of dicaine help. Be sure to carry out treatment of the underlying disease. But in general, drug treatment of blepharospasm is ineffective. Recently, local injections of botulinum toxin (type A) have been used, which causes temporary paralysis of the circular eye muscle,

Surgical treatment of blepharospasm (lylectomy) is carried out with intolerance of botulinum toxin or inefficiency of treatment with this drug.

Blepharospasm is difficult to treat, relapse after the injection of botulinum toxin occurs after 3 to 4 months, which requires repeated injections.

Sunglasses reduce the sensitivity to light, which can cause or accompany blepharospasm.