Blepharospasm is defined as an abnormal, involuntary, sustained and forceful closure or twitching of the eyelids. Blepharospasm is usually associated with headaches, eyebrow strain and occasionally loss of vision.
Isolated blepharospasm is rare and represents a minority of patients presenting with blepharospasm.
Blepharospasm is commonly associated with lower facial spasms as part of a syndrome or disease complex. Some examples are:
· Meige Syndrome: Characterized by spasm of the eyelids and midface.
· Brueghel’s Syndrome: Presents with blepharospasm and marked spasms in the lower face and neck.
· Segmental Cranial Dystonia: In addition to the usual spasms of the eyelids and facial muscles it is associated with spasms along distribution of various cranial nerves, most often involving the Facial Nerve.
· Generalized Dystonia: Presents with spasms across various body parts in addition to blepharospasm and facial spasms
Types of Blepharospasm
Essential or Spontaneous Blepharospasm
A rare focal dystonia without any known cause that affects individuals between 45 and 65 years of age.
Essential blepharospasm is commonly associated with stress, fatigue or an irritant. The symptoms might be benign and transient or might cause significant lifelong challenges to the individual and even cause functional blindness in those rare cases.
Reflex blepharospasm is due to reflex sensory stimulation through branches of the Trigeminal nerve and is common in conditions like phlyctenular conjunctivitis, interstitial keratitis, corneal foreign body, corneal ulcers and iridocyclitis. Excessive stimulation of the retina by dazzling light, stimulation of facial nerve due to central causes, and some hysterical patients also present with reflex blepharospasm. It is due to any pain in and around the eye.