Benign essential blepharospasm BEB is a rare neurological disorder in which affected individuals experience involuntary muscle spasms and contractions of the muscles around the eyes.
These spasms come and go intermittent. Symptoms may begin as eye twitching and blinking and there may be symptoms of eye irritation. Eventually, BEB causes involuntary closure of the eyes. The exact cause of BEB is unknown. The disorder is one of a group of disorders collectively known as adult onset focal dystonias. Dystonia is a group of movement disorders that vary in their symptoms, causes, progression, and treatments.
This group of neurological conditions is generally characterized by involuntary muscle contractions that force the body into abnormal, sometimes painful, movements amoxicillin and clindamycin positions postures. In the early stages, benign essential blepharospasm is characterized by frequent or forced blinking and eye irritation that is often worsened by certain stimuli including bright lights, blepharospasm and aldactone, emotional tension, and environmental factors such as wind or air pollution.
BEB virtually always affects both eyes bilateral. The frequency of muscle spasms and contractions may increase causing involuntary narrowing of the opening between the eyelids or closure of the eyelids.
It may become progressively harder for affected individuals to keep their eyes open. In severe cases, the spasms may intensify to the point where the eyelids are closed several hours at a time. BEB may occur in association with dystonia of the lower part of the face, mouth or jaw. In these cases, BEB may be associated with jaw clenching, grimacing or tongue protrusion. This is called Meige blepharospasm and aldactone or cranial dystonia. BEB may also be associated with abnormally dry eyes.
In most patients, spasms and contractions occur during the daytime and disappear while the individual is sleeping, only to recur the next day. Symptoms of BEB may be temporarily alleviated by a variety of activities including singing, laughing, yawning, and blepharospasm and aldactone. Other activities may worsen symptoms.
Such activities blepharospasm and aldactone reading, blepharospasm and aldactone, walking, watching television, exposure to bright lights, and driving. Stress may also worsen symptoms. The cause of cryotherapy and prostate cancer essential blepharospasm is unknown.
Researchers speculate that the cause of BEB may be multifactorial e. Malfunctioning of a region of the brain known as the basal ganglia may play a role in the development of BEB. The basal ganglia are structures composed of nerve cells located deep in the brain. The basal ganglia are involved in the regulation avastin and taxol for breast cancer motor and learning functions.
The exact problem s associated with the basal ganglia in individuals with BEB is unknown. In some cases, BEB runs in families. In these rare instances, it is more obvious that BEB may be inherited. More study is required to determine the exact role genetics plays in the development of BEB.
In some cases, affected individuals may have a blepharospasm and aldactone of local eye disease such as eye trauma. However, no proven relationship between local eye disease and the development of BEB blepharospasm and aldactone been established. In most affected individuals, BEB develops spontaneously with no known precipitating factor.
Blepharospasm may also occur secondary to other disorders such as tardive dyskinesia or generalized dystonia, Wilson disease, and various parkinsonian syndromes. Benign essential blepharospasm affects women more often than men. The average age of onset is It is estimated that approximately 2, new individuals of BEB are diagnosed cpap and allergies conjunctivitis year in the United States.
The prevalence of BEB in the general population is approximately 5 perindividuals. Symptoms of the following disorders can be similar to those of benign essential blepharospasm. Comparisons may be useful for a blepharospasm and aldactone diagnosis:. Meige syndrome, or cranial dystonia, is a rare neurological disorder that is characterized by spasms of all the muscles of the face, including the tongue and jaw, blepharospasm and aldactone. People in late middle age are most often affected.
Just as in blepharospasm, involuntary eyelid closure may result from spasms of the muscles around the eyes. This disorder is characterized by the sudden onset of facial paralysis only on one side that may be preceded by a slight fever, pain behind the ear on the affected side, or a stiff neck. Dystonia is a group of neurological movement disorders characterized by involuntary muscle contractions. Dystonia may be focal affecting an isolated body partsegmental affecting adjacent body areas, or generalized affecting many major muscle blepharospasm and aldactone simultaneously.
Dystonia may result in abnormal, often painful movements or postures. When dystonia is generalized, it may include blepharospasm.
There are many different causes for dystonia. Genetic as well as non-genetic factors contribute to all forms of dystonia, blepharospasm and aldactone. Hemifacial spasm, which is characterized by spasmodic contractions on one side of the face, is not a form of dystonia. The initial symptom of hemifacial spasm may be twitching of one eyelid that eventually results in brief forced closure of the eyelid. Hemifacial spasm may be caused by pressure on or irritation of the facial nerve.
Hemifacial spasm is only rarely bilateral, blepharospasm and aldactone, and when it is, the spasms are not synchronous on the two sides of the face.
No laboratory tests exist to make a definitive diagnosis of benign essential blepharospasm. A diagnosis is made based upon a thorough clinical evaluation, a detailed patient history and identification of characteristic symptoms. Treatment of BEB consists of oral drug therapy, focal injections of botulinum toxin four different brands are available in the USA or surgery to remove eyelid muscle, used alone or in conjunction with the botulinum toxin injections.
Approximately one-third of affected individuals are treated with oral medications drug therapy specifically anticholinergic drugs and with dopamine depleters such as tetrabenazine. The blepharospasm and aldactone of these drug treatments are usually moderate or unsatisfactory and often temporary. Additional drugs that have been used to treat BEB include clonazepam, trihexyphenidyl, diazepam, blepharospasm and aldactone, and baclofen.
Botulinum toxin has been approved by the Food and Drug Administration FDA as a treatment for blepharospasm and has become the primary form of treatment. The technique of injecting small amounts of botulinum toxin blepharospasm and aldactone the orbicularis oculi weakens these muscles for approximately three months, after which time the procedure must be repeated. Botulinum toxin injections have been helpful for many individuals with blepharospasm, but some people do not respond well.
Botox, distributed by Allergan, and Xeomin, distributed by Merz Pharmaceuticals, are type A botulinum toxin products that are FDA approved for the treatment of blepharospasm. Two surgical approaches are in use in patients in which drug therapy does not work. In a procedure called a protractor myectomy, the eyelid amitryptyline and lipitor themselves are removed either partially or completely.
In the past a procedure known as a neurectomy was performed to treat individuals with BEB. However, blepharospasm and aldactone, the complication rate is much higher than with a myectomy and this procedure is rarely used anymore. In a neurectomy, sections are taken off discounted vitamins and supplements branches of the facial nerve leading to the orbicularis oculi.
Paralysis of the entire upper face may result, but the nerve branches tend to regenerate after a period of months or years.
Dysport, a type A botulinum toxin product, and Myobloc, a type B botulinum toxin product, have been used to treat blepharospasm but are not yet FDA approved for this indication. Information on current clinical trials is posted on the Internet at www. All studies receiving U. For information about clinical trials sponsored by private sources, contact: For information about clinical trials conducted in Europe, contact: Botulinum neurotoxin for the treatment of movement disorders an evidence-based review: Benign Essential Blepharospasm Information Page.
January 14, Available at: The Johns Hopkins University. The content of the website and databases of the National Organization for Rare Disorders NORD is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. About Blepharospasm and aldactone Events Contact. General Discussion Summary Benign essential blepharospasm BEB is a rare neurological disorder in which blepharospasm and aldactone individuals experience involuntary muscle spasms and contractions of the muscles around the eyes.
Introduction Dystonia is a group of movement disorders that vary in their symptoms, causes, progression, and treatments, blepharospasm and aldactone. Causes The cause of benign essential blepharospasm is unknown.
Affected Populations Benign essential blepharospasm affects women more often than men. Related Disorders Symptoms of the following disorders can be similar to those of benign essential blepharospasm. Comparisons may be useful for a differential diagnosis: Diagnosis No laboratory tests exist to make a definitive diagnosis of benign essential blepharospasm. Standard Therapies Treatment Treatment of BEB consists of oral drug blepharospasm and aldactone, focal injections of botulinum toxin four different brands are available in the USA or surgery to remove blepharospasm and aldactone muscle, used alone or in conjunction with the botulinum toxin injections.
Investigational Therapies Dysport, a type A botulinum toxin product, and Myobloc, blepharospasm and aldactone type B botulinum toxin product, have been used to treat blepharospasm but are not yet FDA approved for this indication.
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