Blepharospasm is a neurological disorder characterized by intermittent, involuntary spasms and contractions of the orbicularis oculi (eyelid) muscles around both eyes.
The word blepharospasm is derived from the Greek: βλέφαρον / blepharon, eyelid, and σπασμός / spasmos, spasm, an uncontrolled muscle contraction.
[18] The symptoms may be temporarily alleviated by sensory tricks (geste antagoniste) including stretching or rubbing the eyebrows, eyelids, or forehead,[19] and singing, talking, or humming.
[21] Although blepharospasm is defined as a bilaterally symmetric disorder that affects both eyes, some research has reported unilateral onset.
[16][8] Research in New York and Italy suggests that increased blinking (which may be triggered by dry eyes) leads to blepharospasm.
[35] Hormone replacement therapy for women going through menopause has been found to be associated with dry eyes,[13] which in turn is associated with blepharospasm.
Blepharospasm can be caused by concussions in some rare cases, when a blow to the back of the head damages the basal ganglia.
[6] Diagnosis of blepharospasm has been enhanced by the proposal of objective diagnostic criteria that start from "stereotyped, bilateral and synchronous orbicularis oculi spasms" and proceed to the identification of a "sensory trick" or "increased blinking".
[39] Standard first line treatments of blepharospasm are conservative therapies, oral medication, and periodic injections of botulinum toxin.
[45] The main first-line therapy is periodic injections of botulinum toxin type A to induce localized, partial paralysis of the eyelid muscles.
[46][47] Injections are generally administered at intervals of around 10 weeks, with variations based on patient response and usually give fairly quick relief from the muscle spasms.
[51] Patients suffering from blepharospasm may get relief by wearing spectacles fitted to lift the upper eyelid.
[43] Among complementary therapies, two simulate sensory tricks: Attaching a device to spectacle frames to press on the patient's temple,[52] and applying thin cosmetic tapes to the forehead and eyebrows.
Associated with Joaquin Farias, sensorimotor retraining activities and proprioceptive stimulation aim to induce neuroplasticity, making it possible for patients to recover substantial function that was lost due to blepharospasm.