Blepharospasm
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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The term blepharospasm describes the strong cramping of both eyelids that cannot be influenced. The reason for the eyelid cramp is that a certain eye muscle involuntarily tenses temporarily or constantly. The reason for this usually remains unknown. Blepharospasm occurs predominantly in women of middle to older age. Find out everything you need to know about blepharospasm here.
Blepharospasm: description
Blepharospasm is a bilateral, involuntary eyelid spasm. Its cause remains mostly unknown. The uncontrollable contraction mainly affects the eye ring muscle (Musculus orbicularis oculi), sometimes also other muscles near the eyes. The facial expressions of the person affected are significantly disfigured by the eyelid cramp. Blepharospasm can initially be somewhat asymmetrical or initially manifest as increased blinking or a foreign body sensation. In addition, especially at the beginning of the disease, the eyelid cramp can sometimes be broken by yawning, singing, chewing gum, placing a finger on the temple or other “tricks”.
As the disease progresses, eyelid cramp occurs more and more frequently (every 15 to 20 seconds) and lasts longer (seconds to minutes). This affects vision or even temporarily leads to functional blindness. This is particularly problematic in certain situations, such as when driving a car.
Forms of blepharospasm
Doctors distinguish three forms of blepharospasm:
- Classic blepharospasm: recurrent (clonic) eyelid cramp
- Tonic blepharospasm: permanent contraction that leads to persistent narrowing of the eyelid gap
- Lid opening inhibition type: no apparent spasm of the eye spasm, but a contraction of the forehead muscle. People have difficulty opening their eyes.
frequency
Blepharospasm occurs in three to four in 100,000 people in Europe. It mainly affects women of middle to older age.
Blepharospasm: causes and possible diseases
Blepharospasm is caused by the temporary or permanent involuntary cramping of a certain eye muscle (eye ring muscle, orbicularis oculi muscle). Sometimes other muscles around the eye area are also involved.
Depending on the cause, there are two types of blepharospasm:
- Primary form (essential blepharospasm): No cause for the involuntary eyelid spasm can be identified here.
- Secondary form (symptomatic blepharospasm): The cause here is a nerve or eye disease or damage to the central nervous system.
Most common in the essential blepharospasm. Most people affected report that the symptoms increase under certain conditions, such as emotional stress, stress, bright light, drafts, reading or walking.
Blepharospasm: When Should You See a Doctor?
Complaints in the eye area such as frequent blinking, a foreign body sensation or a temporary or permanent eyelid cramp should generally be clarified by an ophthalmologist. There can be various diseases that require treatment.
Blepharospasm: what does the doctor do?
First, the doctor creates the medical history (anamnesis): In a detailed discussion with the patient, he asks, for example, about the type and start of the symptoms and any underlying illnesses.
Then the inspection of the eyes follows. For example, the blink frequency is determined: it is usually ten to twenty times per minute. Blepharospasm involves blinking more than 27 times per minute (less during a conversation).
Electromyography (EMG) can be used to measure the electrical activity of the eye ring muscle and other relevant muscles. Magnetic resonance imaging (MRI) can help detect certain causes of symptomatic blepharospasm (such as nerve disorders).
It is also important to distinguish it from other possible causes of eyelid cramp. For example, irritation of the conjunctiva or cornea caused by foreign bodies can be detected with the aid of the slit lamp.
This is how the doctor treats blepharospasm
In symptomatic blepharospasm, the cause is treated whenever possible.
Therapy is more difficult in the case of essential blepharospasm, for which no cause can be identified. The use of drugs such as muscle relaxants (muscle relaxants such as baclofen) or sedatives (benzodiazepines such as clonazepam) has a low chance of success and is often associated with serious side effects.
Local injections with the neurotoxin botulinum toxin A are the method of choice in the treatment of blepharospasm. The injection is made subcutaneously (under the skin) directly into the eye ring muscle and paralyzes it. A clinically measurable effect sets in after one to three days and peaks one to two weeks later. Then the effect slowly wears off, so that the injections have to be repeated about every three months. Possible side effects include ptosis (drooping of the upper eyelid) or ectropion (turning the eyelid outwards, usually the lower one).
In some cases, surgery may be required. In this way, for example, those nerve fibers of the facial nerve (nervus facialis) that pull to the eye ring muscle can be cut. A (partial) removal of the muscle is also possible.
Some blepharospasm patients benefit from psychotherapy, biofeedback, hypnosis, or acupuncture.
Blepharospasm: you can do this yourself
At least in the early stages of the disease, symptoms worsen when you are stressed. Then stress reduction and relaxation exercises can offer some help. However, if the symptoms become more severe, do not hesitate to see a doctor. The symptoms will not go away on their own, but worsen, so that drug or surgical treatment is necessary.
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