Paroxysmal involuntary tonic spasm of the eyelids (Latin blepharospasmus) is a problem that is extremely troublesome - it consists in the fact that the patient experiences a strong, involuntary clenching of the eyelids, due to which he is simply unable to time to see nothing. What are the causes of paroxysmal involuntary tonic spasm of the eyelids and what to do when such a disorder occurs - what are the treatment options?
Eyelid spasm , also referred to asparoxysmal involuntary tonic eyelid spasm(blepharospasm, Latinblepharospasmus ) is one of the dystonia that interferes with normal functioning. Various problems are classified as dystonia, including both neck cramps and writers' cramps. Dystonias are one of the types of involuntary movements that are associated with the abnormal activation of various muscles, resulting in the patient assuming often bizarre positions.
Paroxysmal involuntary tonic spasm of the eyelids typically occurs in adults (usually it begins after the age of 50), and for some unknown reason it is more common in women.
Paroxysmal involuntary tonic spasm of the eyelids: causes
Paroxysmal involuntary tonic spasm of the eyelids may develop as primary dystonia or secondary dystonia. The first of these can be said when paroxysmal blepharospasm is an independent disease and in such a situation it is usually caused by genetic conditions - in this case the symptoms of paroxysmal involuntary tonic eyelid spasm may appear already in childhood. However, much more oftenblepharospasmusoccurs as a secondary dystonia, which can be caused by such problems as:
- tumors of the central nervous system
- demyelinating diseases (e.g. multiple sclerosis)
- damage to the tissues of the nervous system (caused by an accident or resulting from a neurosurgical operation)
- poisoning (e.g. with carbon monoxide or methanol)
- Taking certain medications (drugs that are most known to induce dystonia are neuroleptics, or antipsychotics; another drug that can also result in paroxysmal involuntary blepharospasm dystonia if taken over a long period of time.metoclopramide)
- Wilson's disease
- stroke (both hemorrhagic and ischemic)
- leukodystrophy
- electric shock
Paroxysmal involuntary tonic spasm of the eyelids: symptoms
The most characteristic symptom of paroxysmal involuntary tonic spasm of the eyelids are episodes of severe contraction of the eye muscle, resulting in the patient being unable to open his eyes. Such a seizure usually lasts from a few to several seconds. Usuallyblepharospasmusis preceded by the feeling of having a foreign body under the eyelids (e.g. sand), then the patient starts to blink very often, and then the eyelids are tightly closed.
There are various factors that can provoke paroxysmal involuntary spasm of the eyelids, e.g .:
- intense light
- watching TV for a long time
- computer work
- driving a car
- severe stress
It happens, however, that speaking or touching the outer corner of the eye results in the end of strong contraction of the eyelids.
Read also: These symptoms indicate eye strain
Paroxysmal involuntary tonic spasm of the eyelids: diagnosis
The diagnosis and treatment of involuntary paroxysmal tonic blepharospasm is done by neuroscientists.
Initially, their task is to determine whether the blepharospasm is primary or secondary dystonia - to make this task easier for a specialist, you should tell him about the diseases you currently suffer from (but also about diseases that in the past), and inform your doctor about the medications you are taking.
Sometimes the mere fact of collecting a medical history with the patient allows us to gain knowledge about the causes of paroxysmal involuntary tonic spasm of the eyelids, but if there are any doubts, the patient may be ordered an electromyographic examination (EMG).
Paroxysmal involuntary tonic spasm of the eyelids: treatment
Treatment of paroxysmal involuntary tonic spasm of the eyelids can be very different - the treatment depends on the cause of the problem in a given patient.
For example, in those patients who developblepharospasmusas a side effect of their medications, a modification of pharmacotherapy may be sufficient to resolve the problem.
In other cases, pharmacological treatment may be recommended to patients based on the use of drugs such as:
- levodopa
- benzodiazepines
- baclofen
In a situation where drugs are ineffective, botulinum toxin injections (the so-called botulinum toxin) are sometimes used. The aim of such therapy is temporary muscle paralysis and it is effective, but the problem here is that it is necessary to repeat such injections approximately every three months.
In those patients, in whom neither pharmacotherapy nor botulinum toxin injections bring the expected results, surgical treatment may be used, consisting in partial incision of the fibers of the circular muscle of the eye.
Paroxysmal involuntary tonic spasm of the eyelids: prognosis
Just as paroxysmal involuntary tonic spasm of the eyelids can certainly be considered a very bothersome ailment, the good news here is that the prognosis of patients is generally considered good.
Statistically, in one in ten patients, blepharospasm is completely self-limiting after a shorter or longer period of time. In the remaining patients, the problem is usually managed with the use of pharmacotherapy or other methods of treating paroxysmal involuntary tonic contraction of the eyelids.
About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.Read more articles by this author