Midwest Eye Care Institute

Blepharospasm and Hemifacial Spasm

Blepharospasm

Benign essential blepharospasm is the name given to uncontrolled contraction of the muscles that surround the eyelids. The condition is always bilateral (affecting both sides of the face) and in some cases may involve the lower muscles of the face and neck (Meige’s Syndrome).

The cause of blepharospasm is not completely understood, but it is thought to be related to abnormal neural pathways within an area of the brain, referred to as the basal ganglia.

Over the years a number of therapies have been used to treat blepharospasm, including anti-depressive and anticonvulsive medications, however BOTOX® injections have been the first line to treatment for at least the last 10 years. Dr. Conlon has been treating patients with blepharospasm for over 15 years, and is familiar with both the diagnosis and treatment of this disease.

Unfortunately, at the present time there is no cure for blepharospasm, however many patient experience excellent relief from their spasms with periodic BOTOX® injections.

Hemifacial spasm

Hemifacial spasm is characterized by the uncontrolled contracture of muscles on one side of the face. Usually, the left side of the face is more commonly involved, however it may also occur on the right side of the face.

The cause of hemifacial spasm is usually related to irritation of the facial nerve as it exists the brain stem. In many cases, a blood vessel can be seen on magnetic resonance imaging (MRI) touching the facial nerve, which gives rise to uncontrolled contracture of the facial muscles. In a small percentage of patients (<1%), a tumor may be responsible for the irritation of the facial nerve, so imaging is mandatory in all patients with hemi-facial spasm.

The main form of treatment for hemifacial spasm, is BOTOX® injections to the periocular and upper cheek muscles. In some case, there is a surgical option to treat the disease, by neurosurgical microvascular decompression of the nerve; however this is a complex surgical procedure, and should only be considered in carefully selected cases, at a center specializing in this surgical technique.