Blepharospasm

This form of focal dystonia also affects women more frequently than men, with symptoms typically becoming apparent after age 50. The term blepharospasm refers to intermittent or sustained closure of the eyelids due to abnormal, involuntary contractions or spasms of certain muscles that function to close the eyelids. Some individuals with blepharospasm experience relatively mild spasms of the muscle underlying the skin of the eyebrows and the root of the nose as well as of the middle and lower facial muscles. These spasms may resulting grimacing or facial distortions. The condition is sometimes called essential blepharospasm or dystonic blepharospasm.

In some patients, blepharospasm may begin in just one eye (unilateral). Initial signs of the condition include eye irritation and burning, an increased sensitivity to light (photophobia), and excessive blinking. With disease progression, patients may experience narrowing of the opening of the eyelids due to dystonia muscle contractions; involuntary, potentially forceful closure of the eyelids; and an inability to voluntarily raise the eyelids in order to open their eyes.

Excessive blinking and involuntary eyelid closure may be temporarily relieved by certain sensory tricks, including singing, humming, or talking; laughing; yawning; opening the mouth; chewing; or applying pressure on the eyebrows, temple, or skin next to the eyes. These dystonic spasms generally disappear with sleep. In contrast, symptoms may worsen with stress, walking, reading, exposure to bright light, looking upward, watching television, or driving. Accordingly, blepharospasm may cause varying levels of difficulty with daily tasks, including reading and driving. Without treatment, blepharospasm often results in functional blindness, although vision may be normal.

In some patients with blepharospasm, dystonic spasms may extend to nearby cranial areas, such as muscles of the tongue, mouth, jaw, neck, vocal cords, or other areas, thus becoming a segmental dystonia. (Also see description below of Meige syndrome, which involves blepharospasm with lower facial involvement.)

	Oromandibular Dystonia