Nervous tics and twitching of the eyelids occur at any age. But the condition that is called blepharospasm more often develops in the elderly. The patient closes his/her eyes involuntarily. It is important not to miss the onset of the disease so that you can see a doctor as soon as possible.
What is blepharospasm?
This neurologic syndrome, that is, not an independent disease, but a complex of symptoms that accompany various pathologies (which? - we'll talk about this a little later). In fact, it is hyperkinesis - that is, "redundant", "superfluous" movement.
The circular muscle of the eye involuntarily contracts - consequently, the person closes his eyes. It is possible to asymmetric blepharospasm of one eye or symmetrical - both eyes. In 60% of cases, involuntary movements of other mimic muscles are observed, for example, tongue, lower jaw and so on.
Such a syndrome usually develops in people over 50, more often in women.
The main cause of blepharospasm is a violation of the functions of the brain structures. Do not overload the description with redundant details. For understanding, it is important that the brain generates "wrong" impulses, which are transmitted to the muscles and cause them to move.
Predisposing causes for the development of blepharospasm are, also:
• genetic features;
• injuries and regular traumatic surgeries (for example, dental surgery - removal and denture);
• infectious and inflammatory processes localized in the face area - sinusitis, blepharitis and so on;
• neuropathy (impaired sensation) of the facial nerve;
• prolonged tension of the eyes and facial muscles;
• taking drugs from a range of neuroleptics;
It can be noted that all these external factors damage the nerves that transmit the impulse to the circular muscle of the eye (and other mimic muscles). Injuries, infections, overexertion - make this system more vulnerable. And, in the brain functions it "responds" first. Drugs that correct the exchange of neurotransmitters (neuroleptics) can, as a side effect, cause an "incorrect" generation of nerve impulses.
Development of blepharospasm.
The first manifestations of blepharospasm can be:
• blinking and twitching of the eyelids;
• a series of "screw-ups";
• long "screwing up";
• prolonged closing of the eye due to the weakness of the century.
Such phenomena can be asymmetric, that is, affect primarily one eye. Patients may complain of photophobia. Arbitrary control of the movement of the eyelids is lost gradually (that is, at first the person feels the tension and can prevent the squeeze or slow it down).
The phenomena of blepharospasm are intensified in activities related to eye strain, fatigue, negative emotions, and bright light. There are positions of the eyes that suppress hyperkinesis - as a rule, it "retreats" when you lower your eyes or maximally divert your eyes to the side. Also, the patient becomes easier if he/she lies down.
There is a phenomenon of "paradoxical kinesia", that is, in certain situations, blepharospasm is invisible. For example, when a person eats, talks, yawns. But if the doctor asks the patient several times (arbitrarily) to tighten eyes tightly, the syndrome "will return".
In parallel, the patient experiences eye irritation - discomfort, fatigue, dryness, lacrimation, inflammatory processes can develop. This is a natural reaction to excessive blinking. It is important for the doctor to place "accents" correctly and determine what is the cause and what is the consequence.
Diagnosis of blepharospasm.
It is necessary to conduct a detailed diagnosis in order to differentiate this syndrome from other conditions that can cause such symptoms:
• myasthenia gravis;
• eye diseases;
• endocrine disorders;
For example, tics often continue in a dream, when the phenomena of blepharospasm subsided. Hysterical blepharospasm has a clear connection with psychotrauma. Such a condition can be eliminated by a temporary rest (close the eye with the palm for a few minutes). With eye diseases, "squinting" has a reflex character. With myasthenia weakened and the muscles that move the eyeball.
There are many signs that distinguish the primary blepharospasm from the secondary (emerged, as a reaction to other diseases). The specialist identifies them when the patient is questioned and according to the results of the research.
1. If it is caused by other pathologies - the focus is on their treatment. "Close-up" occurs as its cause is eliminated.
2. If blepharospasm is a manifestation of the pathology of the nervous system, drugs of various groups acting on neuromuscular transmission (baclofen (Lioresal), clonazepam, eglonyl, and so on) can be prescribed.
3. With persistent blepharospasm, the phenomena of which are not eliminated by other methods, excision (or coagulation) of the branches of the nerves can be performed. To such an operation resorted to as a last resort.
4. The most modern and effective method of combating blepharospasm are injections of botulinum toxin A. The word "botox" is the name of the most famous drug containing this substance, and it has already become a household word. In medical practice, often used drugs Dysport, Xeomin and others. The patient is injected into the circular muscle of the eye. Within a few days the effect develops - the muscle relaxes, involuntary movements recede. The actions of one procedure last for several months.
Complications of injections can be:
• excessive relaxation and lowering of the eyelids;
• impaired vision.
Most often, discussions about this condition relate to the effectiveness of botox injections (or similar drugs). You can meet a lot of reports from patients who did not immediately receive such injections:
- I've already been used Dysport several times. The first time I did not feel any improvement at all. The second time the dose was increased and the eyes became "calmer". Clonazepam was also prescribed. Of course, this is not a cure, but the maintenance of a normal state. Gradually the symptoms come back and you need to stab the drug again.
- My wife and I were very worried that the injections would not help. Read that there is resistance to botox. And after the first procedure, indeed, there was no effect. But the doctor said that it's too early to panic. A month later they made another injection - there was an improvement.
In some cases, patients complain of complications:
- My upper lip was tightened.
- The eyelid has lowered and in general has ceased to rise.
Such phenomena may result from the incorrect administration of botulinum toxin preparations. Therefore, it is extremely important to make a procedure with a reliable specialist.
A harmonious treatment program was described by one patient:
- Except for injections and drugs, you need to make your own efforts: sleep, rest, maintain the nervous system. It is important to eat right and give up stimulants - coffee, smoking, strong tea. Be sure to do exercises for the muscles of the neck, face and generally do exercises. It is necessary to add to the above the need for correction of vision (if there are violations).