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Blepharospasm

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Introduction / full article

Blepharospasm

ID 481

Blepharospasm

Blepharospasm is a medical condition in which there is abnormal, involuntary blinking or spasm of the eyelids. [1] Normally, an adult blinks about 10 to 20 times per minute and the rate may be reduced by activities such as reading or when in front of a computer monitor. In blepharospasm, there is increased frequency of eyelid closure and tone. When the condition is severe, it may result to blindness. [2]

Blepharospasm  may occur as a result of other conditions like brain injury, drug adverse reaction or neurological condition thus maybe called secondary blepharospasm. However, the disease usually happens without a specific cause. Genetics rarely plays a role. [3]

Epidemiology        

In the United States, at least 50,000 cases of blepharospasm are diagnosed yearly. Prevalence in general population is 5 in 100,000. Females are more affected with 1.8:1 female to male ratio. Mean age of onset is 56 years old.      [4]

Cause

Blepharospasm has been linked to abnormal functioning of the basal ganglia which are found at the base of the brain. The exact cause in unknown. Alterations in chemical messengers are thought to play a role. In most patients, blepharospasm occurs spontaneously. Dry eyes commonly precede and/or simultaneously occur with blepharospasm. Inheritance is rare. Blepharospasm can also be caused by drugs such as anti-Parkinson's medications. [5]

Signs and Symptoms

Patients usually do not manifest with warning symptoms. Blepharospasm may start as gradual increase in blinking or eye irritation. Some individuals may note fatigue, emotional tension, or sensitivity to bright light. Symptoms become more pronounced as the condition progresses and the patient may experience facial spasm as well. Blepharospasm may lessen or cease during a sleep or when the person is concentrated on a certain task. [1] Talking, whistling, touching the face and relaxation may improve the condition while driving and stress may exacerbate it. [2]

Diagnosis

Diagnosis is based on medical history, physical examination and ruling out of other causes. The disease presents same characteristics as others thus may be misdiagnosed or not diagnosed at all.[6]

Treatment

In most cases, botulinum toxin injection is used as muscle relaxant and to stop spasms.[7] Other treatment options include medications such as lithium and diazepam, surgery (myectomy) and stress management. [6]

References:

  1. http://www.nei.nih.gov/health/blepha/blepharospasm.asp
  2. http://www.patient.co.uk/doctor/Blepharospasm.htm
  3. http://www.bbc.co.uk/health/physical_health/conditions/blepharospasm1.shtml
  4. http://emedicine.medscape.com/article/1212176-overview#a0199
  5. http://www.blepharospasm.org/#A6
  6. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Blepharospasm?open
  7. http://www.ninds.nih.gov/disorders/blepharospasm/blepharospasm.htm

 

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